Publicaciones científicas
Evidence and Choice: The BCLC Vision for Tailoring Clinical Decision-Making
Maria Reig 1 , Alejandro Forner 1 , Jordi Rimola 2 , Joana Ferrer-Fàbrega 3 , Marta Burrel 4 , Ángeles Garcia-Criado 5 , Robin K Kelley 6 , Peter R Galle 7 , Vincenzo Mazzaferro 8 , Riad Salem 9 , Bruno Sangro 10 , Amit G Singal 11 , Arndt Vogel 12 , Josep Fuster 3 , Carmen Ayuso 13 , Jordi Bruix 14
We would like to begin by thanking Trevisani et al [1] for the considerable time and effort devoted to evaluating the strengths and limitations of the BCLC approach [2]. They propose a ‘hierarchical approach’, aiming to bridge the gap between evidence-based data and clinical practices in areas lacking comprehensive data. In contrast, the BCLC approach [2] advocates for a patient-centric model, rather than the treatment prioritization suggested by Trevisani et al. [1]. It's important to note that the BCLC 2022 [2] update's specifically in its ‘Clinical Decision Making’ section, allows for personalized management.
Trevisani et al. [1] question the BCLC's rigor in prognostic prediction for HCC, suggesting a need for real-life data-based predictive scores. Their 'hierarchical approach' [1] lacks the same scientific rigor, presenting a contradiction by demanding methodological rigor in prognosis but not in treatment. This inconsistency underlines a flaw in their argument, with most supporting cohorts biased, undermining robust conclusions. Only prospective trials can offer reliable recommendations, underscoring the undervalued potential of systemic therapies in various HCC stages, suggesting a need to revise current treatment approaches.
CITA DEL ARTÍCULO J Hepatol. 2024 May 8:S0168-8278(24)00321-0. doi: 10.1016/j.jhep.2024.04.023
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