Effectiveness of an interdisciplinary approach to early diagnosis of hepatocellular carcinoma

The implementation in the Republic of Sakha (Yakutia) of a set of measures aimed at eliminating parenteral viral hepatitis and improving the provision of medical care to the adult population with oncological diseases has had a significant impact on the effectiveness of hepatocellular carcinoma diagnosis. Patients with advanced fibrosis and cirrhosis of the liver require special attention, as it is in this group of patients that the highest proportion of fatalities is observed, as well as the greatest burden on the healthcare system budget. The aim of the study was to evaluate the impact of an interdisciplinary approach on the etiological verification of the diagnosis and the effectiveness of HCC detection using the example of the Republic of Sakha (Yakutia). The article presents a retrospective analysis was conducted of data from 632 patients with HCC in the Republic of Sakha (Yakutia) who were examined and treated at the Yakutsk Republican Oncology Dispensary, and an analysis of the incidence rate based on official statistics before and after the introduction of the interdisciplinary approach. Due to improved screening, the proportion of patients with viral hepatitis markers increased 2.5 times and approached 70%. Clinical and laboratory diagnosis of liver cirrhosis improved, which is extremely important when choosing a treatment strategy for a patient. The rate of early diagnosis at stage I according to the TNM classification increased from 5.1% to 12.0% over 5 years. The increase in the proportion of patients with early-stage HCC opens up broad opportunities for the use of local tumor destruction methods and is expected to increase the overall survival of patients. It has been shown that an interdisciplinary approach reduces the time it takes to refer a patient from an infectious disease specialist to an oncologist and improves the quality of morphofunctional diagnosis of the liver. The experience of the Republic of Sakha (Yakutia) shows that improving dispensary observation of risk groups and continuity in patient management within the framework of interdisciplinary cooperation between specialists is a promising direction that can ensure early diagnosis of HCC and improve treatment outcomes.