Costentin Charlotte, Ganne-Carrié Nathalie, Rousseau Benoit, Gérolami René, Barbare Jean-Claude
AP-HP, hôpital Henri-Mondor, service d'hépatologie, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94000 Créteil, France.
AP-HP, hôpital Jean-Verdier, service d'hépatologie, avenue du 14-Juillet, 93140 Bondy, France.
Bull Cancer. 2017 Sep;104(9):752-761. doi: 10.1016/j.bulcan.2017.06.008. Epub 2017 Jul 24.
Hepatocellular carcinoma is a major public health problem with one of the highest overall mortality compared to other cancers. The median overall survival in France in a hospital population with hepatocellular carcinoma is 9.4 months. Several publications reported a positive impact of hepatocellular carcinoma screening on diagnosis at an early-stage, eligibility for curative treatment and overall survival. However, the identification of patients to be included in a hepatocellular carcinoma screening program and the application of screening recommendations are not optimal. Other studies suggest a potentially negative impact of delayed diagnosis or treatment initiation on the patient's prognosis. Finally, marked variations between French regions and departments have been described in terms of access to curative treatment and overall survival. In this review article, we propose a state of play of the hepatocellular carcinoma patient's care pathway in France with the aim of identifying potential breaking points with negative impact on prognosis and of developing proposals for improvement.
肝细胞癌是一个重大的公共卫生问题，与其他癌症相比，其总体死亡率是最高的之一。在法国，肝细胞癌住院患者的中位总生存期为9.4个月。几份出版物报道了肝细胞癌筛查对早期诊断、治愈性治疗资格和总生存期有积极影响。然而，确定纳入肝细胞癌筛查计划的患者以及应用筛查建议并不理想。其他研究表明，诊断或治疗开始延迟可能会对患者预后产生负面影响。最后，在获得治愈性治疗和总生存期方面，法国不同地区和部门之间存在显著差异。在这篇综述文章中，我们提出了法国肝细胞癌患者护理路径的现状，目的是确定对预后有负面影响的潜在断点，并提出改进建议。
