Clinical pathway of liver cancer

Liver cancer ranks as the sixth most common type of cancer and third leading cause of cancer death worldwide. Clearly, the underlying diseases, especially disorders of the liver, are the main causes of death from this type of cancer. The low five-year survival rate mainly reflects the poor prognosis, inadequate effectiveness of common treatments, and inefficiency in the provided care. It appears that the designing of an appropriate clinical model of various stages of this disease can improve the adequacy of medical service provided and increase the survival rate of the patients. Thus, the study is designed to develop an appropriate clinical model for managing patients suffering from liver cancer. This study was performed by systematic review method. Evidence published from ۲۰۱۴ to ۲۰۲۴ was searched in international databases Pubmed, WOS, Scopus, and the Google Scholar search engine in English with keywords such as Hepatic Cancer, Surveillance, Symptom Management, Clinical Pathway. The search process and also data analysis in this study were carried out in accordance with the PRISMA checklist. In total, ۸۱۱ articles were found, of which ۲۴ original articles were analyzed in accordance with the inclusion criteria that considered only free-version availability, written in English, and of prospective observational methodology. This study has shown that a lot of challenges in the management of the disease can be resolved with the designing of a seven-step clinical model. These stages include: prevention and early diagnosis (treatment of liver infections and screening of high-risk patients), initial assessments (imaging techniques and laboratory biomarkers), definitive diagnosis of the disease and treatment plan design (determining the treatment plan in a maximum of four weeks), initiation of treatment and management of symptoms, provision of care based on complications resulting from treatment, modification and readjustment of the treatment plan in case of metastasis or recurrence, and provision of end-of-care Life if treatment is not met. The five characteristics of care, namely patient-centered, safe and high-quality care, multidisciplinary supportive care, appropriate communication, research and clinical trials, add to the main steps of managing this disease from prevention to rehabilitation and can be considered as the adequacy of the care provided. Considering the poor prognosis and high cost of treatment in liver cancer patients, it seems necessary that attention should be paid to high-risk individuals, in other words, the prevention of this disease as other stages of treatment and rehabilitation. On the other hand, due to the existence of a specific clinical pattern and sequence, patients are guaranteed access to the same treatment services and appropriate management of their clinical symptoms. A structure that reduces many treatment costs.

کلیدواژه ها:

Hepatic Cancer ، Surveillance ، Symptom Management ، Clinical Pathway ، Cancer Treatment