Hepatocellular carcinoma detected by regular surveillance: Does timely confirmation of diagnosis matter?. Issue 6 (June 2016)

• Record Type: Journal Article
• Authors: Yeh, Jen-Hao; Hung, Chao-Hung; Wang, Jing-Houng; Kuo, Yuan-Hung; Tai, Wei-Chen; Lu, Sheng-Nan
• Is Part Of: Digestive and liver disease. Volume 48:Issue 6(2016)
• Page Start: 661
• Page End: 666
• Publication Date: 2016-06
• Subjects: Chronic hepatitis -- Cirrhosis -- Liver cancer -- Prognosis; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2016.02.018
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: Although current guidelines recommended surveillance of hepatocellular carcinoma, prognosis in patients undergoing enhanced follow-up has yet to be evaluated. Aims: Examine outcomes of hepatocellular carcinoma diagnosed during enhanced follow-up. Methods: During 2010–2012, 194 patients underwent ultrasonography surveillance were diagnosed with hepatocellular carcinoma and divided into: (A) immediate diagnosis ( N = 105, 54.1%) after positive ultrasonography, (B) enhanced follow-up: ( N = 38, 19.6%) for initial negative recall procedures, (C) late call back: ( N = 28, 14.4%) recall procedures were deferred after positive ultrasonography, and (D) beyond ultrasonography: ( N = 23, 11.9%) surveillance ultrasonography had been negative. Results: Median time from positive ultrasonography to confirmation of hepatocellular carcinoma were 9.5 months (2–67) in the Group B and 6.5 months (3–44) in the Group C. Stage distribution and 3-year survival rates were similar amongst all Groups. Surveillance intervals longer than 6 months were associated with the non-curative stage (3.7% vs. 12.5%, p = 0.04). Nine (4.6%) patients underwent surveillance were diagnosed as Barcelona-Clinic Liver Cancer stage C. Conclusion: Enhanced follow-up by current guidelines is appropriate that treatment can be deferred until a definite diagnosis. Despite optimal surveillance interval and recall policies, few non-curative stage diagnoses seemed inevitable under current standard of care.