Surveillance for hepatocellular carcinoma with a 3-months interval in "extremely high-risk" patients does not further improve survival. Issue 7 (July 2022)

• Record Type: Journal Article
• Authors: Pelizzaro, Filippo; Peserico, Giulia; D'Elia, Marco; Cazzagon, Nora; Russo, Francesco Paolo; Vitale, Alessandro; Giannini, Edoardo G.; Piccinnu, Manuela; Rapaccini, Gian Ludovico; Di Marco, Maria; Caturelli, Eugenio; Zoli, Marco; Sacco, Rodolfo; Cabibbo, Giuseppe; Marra, Fabio; Mega, Andrea; Morisco, Filomena; Gasbarrini, Antonio; Svegliati-Baroni, Gianluca; Foschi, Francesco Giuseppe; Olivani, Andrea; Masotto, Alberto; Nardone, Gerardo; Raimondo, Giovanni; Azzaroli, Francesco; Vidili, Gianpaolo; Oliveri, Filippo; Trevisani, Franco; Farinati, Fabio; Biselli, Maurizio; Caraceni, Paolo; Garuti, Francesca; Gramenzi, Annagiulia; Neri, Andrea; Santi, Valentina; Piscaglia, Fabio; Tovoli, Francesco; Granito, Alessandro; Muratori, Luca; Benevento, Francesca; Dajti, Elton; Marasco, Giovanni; Ravaioli, Federico; Cappelli, Alberta; Golfieri, Rita; Mosconi, Cristina; Renzulli, Matteo; Imondi, Angela; Sartori, Anna; Penzo, Barbara; Pinto, Elisa; Cela, Ester Marina; Facciorusso, Antonio; Cacciato, Valentina; Casagrande, Edoardo; Moscatelli, Alessandro; Pellegatta, Gaia; De Matthaeis, Nicoletta; Allegrini, Gloria; Lauria, Valentina; Ghittoni, Giorgia; Pelecca, Giorgio; Chegai, Fabrizio; Coratella, Fabio; Ortenzi, Mariano; Missale, Gabriele; Inno, Alessandro; Marchetti, Fabiana; Busacca, Anita; Cabibbo, Giuseppe; Cammà, Calogero; Di Martino, Vincenzo; Rizzo, Giacomo Emanuele Maria; Franzè, Maria Stella; Saitta, Carlo; Sauchella, Assunta; Bevilacqua, Vittoria; Borghi, Alberto; Casadei Gardini, Andrea; Conti, Fabio; Dall'aglio, Anna Chiara; Ercolani, Giorgio; Mirici, Federica; Campani, Claudia; Di Bonaventura, Chiara; Gitto, Stefano; Coccoli, Pietro; Malerba, Antonio; Guarino, Maria; Brunetto, Maurizia; Romagnoli, Veronica;
• Is Part Of: Digestive and liver disease. Volume 54:Issue 7(2022)
• Page Start: 927
• Page End: 936
• Publication Date: 2022-07
• Subjects: Cancer stage -- Hepatocellular carcinoma -- Surveillance interval -- Survival; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2021.08.025
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: An enhanced surveillance schedule has been proposed for cirrhotics with viral etiology, who are considered at extremely high-risk of hepatocellular carcinoma (HCC). Aims: We compared the 3- and 6-months surveillance interval, evaluating cancer stage at diagnosis and patient survival. Methods: Data of 777 HBV and HCV cirrhotic patients with HCC diagnosed under a 3-months ( n = 109, 3MS group) or a 6-months ( n = 668, 6MS group) surveillance were retrieved from the Italian Liver Cancer database. Survival in the 3MS group was considered as observed and adjusted for lead-time bias, and survival analysis was repeated after a propensity score matching. Results: The 3-months surveillance interval neither reduced the share of patients diagnosed outside the Milano criteria, nor increased their probability to receive curative treatments. The median survival of 6MS patients (55.0 months [45.9–64.0]) was not significantly different from the observed (47.0 months [35.0–58.9]; p = 0.43) and adjusted (44.9 months [33.4–56.4]; p = 0.30) survival of 3MS patients. A propensity score analysis confirmed the absence of a survival advantage for 3MS patients. Conclusions: A tightening of surveillance schedule does not increase the diagnosis of early-stage tumors, the feasibility of curative treatments and the survival. Therefore, we should maintain the 6-months interval in the surveillance of viral cirrhotics.