A training program for primary care physicians improves the effectiveness of ultrasound surveillance of hepatocellular carcinoma
A training program for primary care physicians improves the effectiveness of ultrasound surveillance of hepatocellular carcinoma
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DOI：
10.1097/meg.0000000000000404
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发表时间：
2015-09-01
影响因子：
2.1
通讯作者：
Stroffolini, Tommaso
中科院分区：
文献类型：
--
作者：
Del Poggio, Paolo;Olmi, Stefano;Stroffolini, Tommaso
背景和目的肝硬化是肝细胞癌（HCC）的主要危险因素，但只有少数肝硬化患者被初级保健医生（PCP）转诊给肝病专家，并接受定期超声监测。本研究的目的是确定是否有针对性的培训计划，以PCP可以提高在现实生活中的setting.Patients和methodsA的有效性，在意大利地区的肝癌发病率很高，共120 PCP进行了培训，以确定肝硬化患者，将他们转介到该地区的肝病中心，并开始定期超声监测。临床特征，治疗结果，和培训后在同一中心连续190例HCC患者的生存率进行了比较，244例HCC从同一地区的培训前，和232例HCC转介未经培训的PCP从其他areas.ResultsTrained PCP转介显着更多的HCC患者在监测和早期阶段检测（巴塞罗那诊所肝癌-A），适用于根治性治疗。在干预地区，培训后HCC患者的3年和5年生存率分别从35%和20%提高到48%和40%（P
Background and aimsCirrhosis is the main risk factor of hepatocellular carcinoma (HCC), but only a minority of cirrhotic patients are referred to the hepatologist by primary care physicians (PCP) and receive regular ultrasound surveillance. The aim of this study was to determine whether a training program targeted to PCP could enhance the effectiveness of surveillance in a real-life setting.Patients and methodsA total of 120 PCP in an Italian area with a high incidence of HCC were trained to identify cirrhotic patients, to refer them to the Hepatology Centers of the area, and to start regular ultrasound surveillance. Clinical characteristics, outcome of treatments, and survival of 190 consecutive HCC patients in the same centers after training were compared with 244 HCC referred from the same area before training, and to 232 HCC referred by untrained PCP from other areas.ResultsTrained PCP referred significantly more HCC patients detected under surveillance and at an early stage (Barcelona Clinic Liver Cancer-A), suitable for radical treatments. In the intervention area, the 3 and 5-year survival of HCC patients increased after training from 35 to 48% and from 20 to 40%, respectively (P