Coordinator: Loreto Boix
The e-CATCH platform is intended to provide support based on scientific evidence for doctors treating patients with liver cancer. This neoplasia was considered relatively uncommon until a few years ago and the experience needed to handle this properly does not reach the level found in other types such as breast, lung or colorectal neoplasias. In fact the diagnostic and stadiage process requires detailed radiological examinations as well as a clinical valuation taking into account the tumour load, the general condition of the patient and the degree of hepatic function deterioration.
The results of tomography or magnetic resonance are often controversial, directed biopsy is not conclusive or cannot be carried out and finally the therapeutic decision may be controversial. At the present time the treatments that can be applied for curative purposes in an initial phase are surgical resection, transplant or ablation, and their recommendation requires a multidimensional evaluation. In intermediate or advanced phases of the disease the treatments to be considered are chemoembolisation and systemic agents such as sorafenib or lenvantinib in 1st line, or regorafenib, cabozantinib or ramucirumab in 2nd line.
The existing alternatives beyond these options should be considered experimental. This platform enables an independent review of all the documents and results obtained. The reviewers are professionals from the Liver Oncology group (BCLC) of the CIBEREHD with lengthy experience in this field and their recommendations are always based on the scientific evidence collected in the different diagnosis and treatment guides in which the same experts have exercised a leadership role.
One of these that deserves mention is the guide jointly prepared by the Asociación Española para el Estudio de Hígado (AEEH), the Sociedad Española de Oncología Médica (SEOM), the Sociedad Española de Radiología (SERAM), the Sociedad Española de Radiología Vascular e Intervencionista (SERVEI) and the Sociedad Española de Trasplante Hepático (SETH) (Forner et al. Med Clin (Barc) 2009 Feb 28;132(7):272-87). Its content is similar to that of the guides of the European Association for the Study of the Liver (EASL) (J Hepatol. 2014 Feb;60(2):392-420) and of the American Association for the Study of Liver Diseases (AASLD) or the European Society of Medical Oncology (ESMO).
Access to the platform requires a record of the doctor being consulted in order to guarantee that exchange between doctors is maintained, since the aim of this platform is not to give opinions on questions brought up by the possible patients or their relatives. The process is straightforward, there are telephone numbers and contact emails for solving any difficulties, and current legislation on data protection is complied with at all times. e-CATCH.