患者和医生对晚期 HCC 疾病和治疗的期望：前瞻性 PERCEPTION1 研究

IF 9.5 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

JHEP Reports Pub Date : 2024-08-22 DOI:10.1016/j.jhepr.2024.101192

Jean-Charles Nault , Nanthara Sritharan , Gontran Verset , Ivan Borbath , Marie Lequoy , Manon Allaire , Hélène Regnault , Isabelle Colle , Hans Orlent , Isabelle Sinapi , Christophe Moreno , Edouard Larrey , Sabrina Sidali , Clémence Hollande , Giuliana Amaddeo , Stanislas Pol , Pierre Nahon , Nathalie Ganne-Carrié , Vincent Levy , Coralie Bloch-Queyrat , Mohammed Bouattour

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引用次数: 0

摘要

Background & AimsWe aims to explore patients expectations regarding their treatments and prognosis in comparison to physicians' assessments in patients with advanced hepatocellular carcinoma (HCC) in patients receiving systemic treatment.MethodsWe prospectedrolled 205 patients with Barcelona Clinic Liver Cancer (BCLC) stage B/C HCC receiving systemic treatment (NCT04823754).我们在法国和比利时前瞻性地招募了205名接受系统治疗的巴塞罗那肝癌（BCLC）B/C期HCC患者（NCT04823754）。患者填写了一份包含 28 个问题的调查问卷以及医院焦虑抑郁量表（HADS），而医生则在初次会诊后填写了一份包含 17 个问题的调查问卷。结果患者的中位年龄为68岁，75%患有BCLC C型HCC；86.3%接受了阿特珠单抗/贝伐单抗治疗。60%的患者未与医生讨论预期寿命。63%的患者认为自己的预期寿命为 5 年。在患者和医生共同提出的问题中，有 36.4% 的人意见一致；主要差异集中在预期寿命上，患者比医生更乐观。就诊时间较短（p = 0.003）、女医生（p = 0.02）、BCLC C（p = 0.03）和每位医生每年接诊 100 例 HCC 患者（p = 0.008）而言，患者与医生之间的一致性较低。与法国相比，比利时患者对会诊的满意度更高（p = 0.001），但对预期寿命的乐观程度较低。根据 HADS，52% 的患者患有焦虑/抑郁症，而焦虑/抑郁症与甲胎蛋白水平相关（p = 0.03）。医生预测的中位总生存期为 18 个月，而观察到的总生存期为 13 个月（弱相关性，ρ = 0.31）。影响和意义：这项在法国和比利时进行的多中心前瞻性研究主要针对接受系统治疗的晚期肝细胞癌患者。我们的研究结果表明，患者和医生对晚期肝细胞癌系统治疗的期望值存在差异，法国和比利时之间的差异也很大。这些结果表明，有必要采取有针对性的干预措施，以增强患者对自身疾病的理解，并促进患者与医生之间更好的沟通。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Patient and physician expectations regarding disease and treatment of advanced HCC: The prospective PERCEPTION1 study

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Patient and physician expectations regarding disease and treatment of advanced HCC: The prospective PERCEPTION1 study

Background & Aims

We aimed to explore patient expectations regarding their treatments and prognosis in comparison to physicians' assessments in patients with advanced hepatocellular carcinoma (HCC) receiving systemic treatments.

Methods

We prospectively enrolled 205 patients in France and Belgium with Barcelona Clinic Liver Cancer (BCLC) stage B/C HCC receiving systemic treatment (NCT04823754). Patients completed a 28-question survey and the hospital anxiety and depression scale (HADS), while physicians filled a 17-question survey after the initial consultation. Univariate and multivariate models were used to assess factors associated with concordant patient-physician responses, HADS, as well as predicted (by physicians) and observed overall survival.

Results

Patients had a median age of 68 years with 75% having BCLC C HCC; 86.3% received atezolizumab/bevacizumab. 60% of patients did not discuss life expectancy with the physician. 63% of the patients believed they had a life expectancy >5 years. Among shared questions between patients and physicians, 36.4% concordance was observed; major differences centered on life expectancy with patients more optimistic than physicians. A lower patient-physician concordance was seen with shorter-consultations (p = 0.003), female physicians (p = 0.02), BCLC C (p = 0.03) and >100 HCC patients/year per physician (p = 0.008). Compared to France, patients from Belgium were more likely to be satisfied with the consultation (p <0.001) but were less optimistic about life expectancy. Using HADS, 52% of the patients had anxiety/depression that was correlated with alpha-fetoprotein level (p = 0.03). The predicted median overall survival by physicians was 18 months vs. 13 months for the observed overall survival (weak correlation, ρ = 0.31).

Conclusion

Expectations regarding systemic treatments for advanced HCC differ significantly between patients and physicians, showing notable variations across countries.

Impact and implications:

This multicentric prospective study, conducted in France and Belgium, focuses on patients with advanced hepatocellular carcinoma undergoing systemic treatments. The findings of our study underscore the disparities in expectations regarding systemic treatments for advanced hepatocellular carcinoma between patients and physicians, revealing also significant variations between France and Belgium. These results suggest the need for targeted interventions aimed at enhancing patients' comprehension of their disease and fostering better communication between patients and physicians.

Clinical trial number

NCT04823754.

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来源期刊

JHEP Reports GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

12.40

自引率

2.40%

发文量

161

审稿时长

36 days

期刊介绍： JHEP Reports is an open access journal that is affiliated with the European Association for the Study of the Liver (EASL). It serves as a companion journal to the highly respected Journal of Hepatology. The primary objective of JHEP Reports is to publish original papers and reviews that contribute to the advancement of knowledge in the field of liver diseases. The journal covers a wide range of topics, including basic, translational, and clinical research. It also focuses on global issues in hepatology, with particular emphasis on areas such as clinical trials, novel diagnostics, precision medicine and therapeutics, cancer research, cellular and molecular studies, artificial intelligence, microbiome research, epidemiology, and cutting-edge technologies. In summary, JHEP Reports is dedicated to promoting scientific discoveries and innovations in liver diseases through the publication of high-quality research papers and reviews covering various aspects of hepatology.