Factors and Survival Implications associated with biopsy of hepatocellular carcinoma. Issue 7 (July 2021)

• Record Type: Journal Article
• Authors: Rho, Young S.; Pagano, Ian; Wong, Linda L.; Kwee, Sandi A.; Acoba, Jared D.
• Is Part Of: HPB. Volume 23:Issue 7(2021)
• Page Start: 1054
• Page End: 1060
• Publication Date: 2021-07
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2020.11.001
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Hepatocellular carcinoma (HCC) is one of the few cancers that can be diagnosed based on imaging findings alone. The factors associated with the decision to perform a biopsy and the clinical impact have not been previously studied. Methods: We collected data of patients diagnosed with HCC between 2004 and 2015 from the National Cancer Database. We assessed associations between biopsy and survival with demographic and clinical factors. Results: We included 160, 507 patients. The median age was 62 (40–90), 74.1% were male and 74.9% were white. Over the 12-year period, 47.7% (76, 524/160, 517) underwent a biopsy. Factors associated with a biopsy were black race, older age, presence of metastatic disease, larger tumor size, and treatment at a community cancer center. Factors associated with increased mortality were older age, higher comorbidity index, larger tumor size, presence of metastatic disease, higher AFP and elevated bilirubin. There was a significant decreased use of biopsy over successive years (2007–2015). After adjusting for prognostic factors, biopsy had no significant impact on survival HR 1.01 (95%CI 1.00–1.03. p = 0.07). Conclusions: A significant number of patients underwent a biopsy. Performing a biopsy did not have a significant impact on survival.