Evaluation of Ultrasound-based Surveillance for Hepatocellular Carcinoma in Patients at Risk: Results From a German Multicenter Retrospective Cohort Study.
Hepatocellular carcinoma
Screening
Surveillance success
Ultrasound
Journal
Journal of clinical and translational hepatology
ISSN: 2310-8819
Titre abrégé: J Clin Transl Hepatol
Pays: United States
ID NLM: 101649815
Informations de publication
Date de publication:
28 Jun 2023
28 Jun 2023
Historique:
received:
25
04
2022
revised:
17
07
2022
accepted:
21
09
2022
entrez:
27
3
2023
pubmed:
28
3
2023
medline:
28
3
2023
Statut:
ppublish
Résumé
Hepatocellular carcinoma (HCC) surveillance in patients at risk is strongly recommended and usually performed by ultrasound (US) semiannually with or without alfa-fetoprotein (AFP) measurements. Quality parameters except for surveillance intervals have not been strictly defined. We aimed to evaluate surveillance success and risk factors for surveillance failure. Patients with ≥1 US prior to HCC diagnosis performed at four tertiary referral hospitals in Germany between 2008 and 2019 were retrospectively analyzed. Surveillance success was defined as HCC detection within Milan criteria. Only 47% of 156 patients, median age 63 (interquartile range: 57-70) years, 56% male, and 96% with cirrhosis, received recommended surveillance modality and interval. Surveillance failure occurred in 29% and was significantly associated with lower median model for end-stage liver disease (MELD) score odds ratio (OR) 1.154, 95% confidence interval (CI): 1.027-1.297, US-based HCC surveillance in patients at risk frequently fails and its failure is associated with unfavorable patient-related outcomes. Lower MELD score and HCC localization within right liver lobe were significantly associated with surveillance failure.
Sections du résumé
Background and Aims
UNASSIGNED
Hepatocellular carcinoma (HCC) surveillance in patients at risk is strongly recommended and usually performed by ultrasound (US) semiannually with or without alfa-fetoprotein (AFP) measurements. Quality parameters except for surveillance intervals have not been strictly defined. We aimed to evaluate surveillance success and risk factors for surveillance failure.
Methods
UNASSIGNED
Patients with ≥1 US prior to HCC diagnosis performed at four tertiary referral hospitals in Germany between 2008 and 2019 were retrospectively analyzed. Surveillance success was defined as HCC detection within Milan criteria.
Results
UNASSIGNED
Only 47% of 156 patients, median age 63 (interquartile range: 57-70) years, 56% male, and 96% with cirrhosis, received recommended surveillance modality and interval. Surveillance failure occurred in 29% and was significantly associated with lower median model for end-stage liver disease (MELD) score odds ratio (OR) 1.154, 95% confidence interval (CI): 1.027-1.297,
Conclusions
UNASSIGNED
US-based HCC surveillance in patients at risk frequently fails and its failure is associated with unfavorable patient-related outcomes. Lower MELD score and HCC localization within right liver lobe were significantly associated with surveillance failure.
Identifiants
pubmed: 36969893
doi: 10.14218/JCTH.2022.00201
pii: JCTH.2022.00201
pmc: PMC10037515
doi:
Types de publication
Journal Article
Langues
eng
Pagination
626-637Informations de copyright
© 2023 Authors.
Déclaration de conflit d'intérêts
MB has obtained travel support from Pfizer. FF, PR, GA, HMS, JG, DN, MR, LL, FK, MN, PH, CS have no conflict of interests related to this publication.
Références
Clin Gastroenterol Hepatol. 2014 Nov;12(11):1927-33.e2
pubmed: 24582947
PLoS Med. 2014 Apr 01;11(4):e1001624
pubmed: 24691105
Am J Gastroenterol. 2002 Mar;97(3):734-44
pubmed: 11922571
Hepatology. 1992 Jul;16(1):132-7
pubmed: 1352268
Cancer Prev Res (Phila). 2012 Sep;5(9):1124-30
pubmed: 22846843
Am J Med. 1996 Oct;101(4):422-34
pubmed: 8873514
Hepatol Int. 2017 Jul;11(4):317-370
pubmed: 28620797
Liver Int. 2015 Sep;35(9):2155-66
pubmed: 25752327
Clin Gastroenterol Hepatol. 2012 Dec;10(12):1342-1359.e2
pubmed: 23041539
Br J Cancer. 2013 Jan 15;108(1):222-8
pubmed: 23169288
Eur J Cancer Prev. 2017 Sep;26(5):368-377
pubmed: 27111112
Hepatogastroenterology. 1998 Aug;45 Suppl 3:1214-20
pubmed: 9730377
Gastroenterology. 2018 Aug;155(2):431-442.e10
pubmed: 29729258
JAMA Oncol. 2017 Dec 1;3(12):1683-1691
pubmed: 28983565
Can J Gastroenterol Hepatol. 2015 Jun-Jul;29(5):267-73
pubmed: 26076226
Gastroenterology. 1985 Aug;89(2):259-66
pubmed: 2408960
Hepatology. 2014 Jun;59(6):2188-95
pubmed: 24375711
Am J Gastroenterol. 2013 Mar;108(3):425-32
pubmed: 23337478
Gastroenterology. 2017 Mar;152(4):812-820.e5
pubmed: 27889576
Aliment Pharmacol Ther. 2009 Jul;30(1):37-47
pubmed: 19392863
Aliment Pharmacol Ther. 2017 Jan;45(1):169-177
pubmed: 27862091
Hepatology. 2010 Jun;51(6):1972-8
pubmed: 20209604
J Clin Gastroenterol. 2019 Jan;53(1):65-70
pubmed: 29629906
Liver Int. 2015 Jul;35(7):1862-71
pubmed: 25524812
N Engl J Med. 1996 Mar 14;334(11):693-9
pubmed: 8594428
Clin Gastroenterol Hepatol. 2015 Mar;13(3):594-601.e1
pubmed: 25148760
Curr Opin Gastroenterol. 2013 May;29(3):285-92
pubmed: 23507917
Gastroenterology. 2018 May;154(6):1706-1718.e1
pubmed: 29425931
J Hepatol. 2014 Jan;60(1):110-7
pubmed: 23978719
Hepatology. 2011 Dec;54(6):1987-97
pubmed: 22144108
J Hepatol. 2018 Jul;69(1):182-236
pubmed: 29628281
Hepatology. 2018 Jan;67(1):358-380
pubmed: 28130846
J Hepatol. 2014 Aug;61(2):333-41
pubmed: 24717522
J Hepatol. 2018 Mar;68(3):526-549
pubmed: 28989095
CA Cancer J Clin. 2018 Nov;68(6):394-424
pubmed: 30207593
J Hepatol. 2010 Aug;53(2):291-7
pubmed: 20483497
Eur J Gastroenterol Hepatol. 2020 Mar;32(3):406-419
pubmed: 31490419
Dig Dis Sci. 2020 Dec;65(12):3456-3462
pubmed: 32860090
Radiol Clin North Am. 2017 Nov;55(6):1197-1209
pubmed: 28991560
J Natl Cancer Inst Monogr. 1997;(22):15-9
pubmed: 9709269