Hepatocellular Carcinoma Surveillance Patterns and Outcomes in Patients With Cirrhosis.
| Title: | Hepatocellular Carcinoma Surveillance Patterns and Outcomes in Patients With Cirrhosis. |
|---|---|
| Authors: | Daher D; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Seif El Dahan K; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Cano A; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Gonzales M; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Ransom C; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Jaurez E; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Carranza O; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Quirk L; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Morgan T; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Gopal P; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Patel MS; Department of Surgery, UT Southwestern Medical Center, Dallas, Texas.; Lieber S; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Louissaint J; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Cotter TG; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; VanWagner LB; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Yang JD; Department of Internal Medicine, Cedars Sinai Medical Center, Los Angeles, California.; Parikh ND; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.; Yopp A; Department of Surgery, UT Southwestern Medical Center, Dallas, Texas.; Rich NE; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Singal AG; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas. Electronic address: amit.singal@utsouthwestern.edu. |
| Source: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2024 Feb; Vol. 22 (2), pp. 295-304.e2. Date of Electronic Publication: 2023 Aug 12. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: W.B. Saunders for the American Gastroenterological Association Country of Publication: United States NLM ID: 101160775 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1542-7714 (Electronic) Linking ISSN: 15423565 NLM ISO Abbreviation: Clin Gastroenterol Hepatol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : W.B. Saunders for the American Gastroenterological Association, 2003- |
| MeSH Terms: | Carcinoma, Hepatocellular*/diagnosis ; Carcinoma, Hepatocellular*/epidemiology ; Carcinoma, Hepatocellular*/therapy ; Liver Neoplasms*/diagnosis ; Liver Neoplasms*/epidemiology ; Liver Neoplasms*/therapy; alpha-Fetoproteins/analysis ; Liver Cirrhosis/pathology ; Humans ; Retrospective Studies ; Ultrasonography |
| Abstract: | Background & Aims: Hepatocellular carcinoma (HCC) surveillance is associated with improved early detection and reduced mortality, although practice patterns and effectiveness vary in clinical practice. We aimed to characterize HCC surveillance patterns in a large, diverse cohort of patients with HCC.; Methods: We conducted a retrospective cohort study of patients diagnosed with HCC between January 2008 and December 2022 at 2 large US health systems. We recorded imaging receipt in the year before HCC diagnosis: ultrasound plus α-fetoprotein (AFP), ultrasound alone, multiphasic contrast-enhanced computed tomography (CT)/magnetic resonance imaging (MRI), and no liver imaging. We used multivariable logistic and Cox regression analysis to compare early tumor detection, curative treatment receipt, and overall survival between surveillance strategies.; Results: Among 2028 patients with HCC (46.7% Barcelona Clinic Liver Cancer stage A), 703 (34.7%) had ultrasound plus AFP, 293 (14.5%) had ultrasound alone, 326 (16.1%) had multiphasic CT/MRI, and 706 (34.8%) had no imaging in the year before HCC diagnosis. Over the study period, proportions without imaging were stable, whereas use of CT/MRI increased. Compared with no imaging, CT/MRI and ultrasound plus AFP, but not ultrasound alone, were associated with early stage HCC detection and curative treatment. Compared with ultrasound alone, CT/MRI and ultrasound plus AFP were associated with increased early stage detection.; Conclusions: HCC surveillance patterns vary in clinical practice and are associated with differing clinical outcomes. While awaiting data to determine if CT or MRI surveillance can be performed in a cost-effective manner in selected patients, AFP has a complementary role to ultrasound-based surveillance, supporting its adoption in practice guidelines.; (Copyright © 2024 AGA Institute. Published by Elsevier Inc. All rights reserved.) |
| Comments: | Comment in: Clin Gastroenterol Hepatol. 2024 Jun;22(6):1340. doi: 10.1016/j.cgh.2023.09.039.. (PMID: 37866683) |
| References: | J Cancer Res Clin Oncol. 2004 Jul;130(7):417-22. (PMID: 15042359); Clin Gastroenterol Hepatol. 2022 May;20(5):1177-1179.e4. (PMID: 34391921); Gastroenterology. 2019 Nov;157(5):1253-1263.e2. (PMID: 31374215); Liver Transpl. 2022 Dec;28(12):1865-1875. (PMID: 35980600); Hepatol Commun. 2022 Jan;6(1):223-236. (PMID: 34558830); Hepatol Int. 2017 Jul;11(4):317-370. (PMID: 28620797); J Hepatol. 2018 Oct;69(4):896-904. (PMID: 29886156); Hepatology. 2023 Dec 1;78(6):1922-1965. (PMID: 37199193); Hepatology. 2024 Jan 1;79(1):107-117. (PMID: 37401857); Radiology. 2023 Apr;307(2):e220917. (PMID: 36692401); J Natl Compr Canc Netw. 2019 Apr 1;17(4):322-329. (PMID: 30959469); Cancer. 2018 Feb 15;124(4):743-751. (PMID: 29072773); J Hepatol. 2010 Aug;53(2):291-7. (PMID: 20483497); Clin Gastroenterol Hepatol. 2014 May;12(5):870-7. (PMID: 24095974); J Hepatol. 2022 Jul;77(1):128-139. (PMID: 35139400); Gastroenterology. 2021 Jun;160(7):2572-2584. (PMID: 33705745); Am J Gastroenterol. 2016 Jul;111(7):967-75. (PMID: 27166130); Clin Gastroenterol Hepatol. 2022 Jan;20(1):9-18. (PMID: 32961340); Cell Metab. 2022 Jul 5;34(7):969-977.e2. (PMID: 35793659); Aliment Pharmacol Ther. 2022 Mar;55(6):683-690. (PMID: 35170052); J Hepatol. 2020 Feb;72(2):250-261. (PMID: 31954490); Health Rep. 2012 Jun;23(2):33-8. (PMID: 22866538); J Natl Compr Canc Netw. 2021 May 28;19(9):1063-1071. (PMID: 34077908); Clin Transl Gastroenterol. 2017 Jun 22;8(6):e101. (PMID: 28640287); Clin Gastroenterol Hepatol. 2023 Apr;21(4):1094-1096.e2. (PMID: 34965448); Hepatol Commun. 2023 Mar 7;7(3):. (PMID: 36881615); JHEP Rep. 2021 Nov 04;4(1):100390. (PMID: 34977518); J Hepatol. 2023 Jul;79(1):226-239. (PMID: 36854345); Clin Gastroenterol Hepatol. 2023 Apr;21(4):1091-1093.e3. (PMID: 34902571); JAMA Netw Open. 2022 Jul 1;5(7):e2223504. (PMID: 35867057); J Hepatol. 2023 Jan;78(1):207-216. (PMID: 36089157); Hepatology. 2018 Jan;67(1):401-421. (PMID: 28859233); Clin Gastroenterol Hepatol. 2023 Jun;21(6):1649-1651.e2. (PMID: 35413448); J Hepatol. 2022 Mar;76(3):681-693. (PMID: 34801630); Clin Gastroenterol Hepatol. 2022 Dec;20(12):2818-2825.e1. (PMID: 34902568); Clin Gastroenterol Hepatol. 2023 May;21(5):1169-1177. (PMID: 35940513); Hepatology. 2020 Nov;72(5):1654-1665. (PMID: 32017165); N Engl J Med. 1996 Mar 14;334(11):693-9. (PMID: 8594428); Gastroenterology. 2018 May;154(6):1706-1718.e1. (PMID: 29425931); J Hepatol. 2018 Jul;69(1):182-236. (PMID: 29628281); Clin Gastroenterol Hepatol. 2022 Jan;20(1):204-215.e6. (PMID: 33618022); Clin Gastroenterol Hepatol. 2019 Feb;17(3):551-559.e1. (PMID: 29859983); Hepatology. 2018 Jul;68(1):78-88. (PMID: 29023828); Am J Med. 2015 Jan;128(1):90.e1-7. (PMID: 25116425); Clin Gastroenterol Hepatol. 2022 Jul;20(7):1561-1569.e4. (PMID: 34119640); Hepatology. 2021 Feb;73(2):713-725. (PMID: 32383272); Clin Gastroenterol Hepatol. 2020 Nov;18(12):2650-2666. (PMID: 31401364); Clin Gastroenterol Hepatol. 2021 May;19(5):987-995.e1. (PMID: 32629122); Nat Rev Dis Primers. 2021 Jan 21;7(1):6. (PMID: 33479224); Hepatol Commun. 2021 Sep;5(9):1481-1489. (PMID: 34510836); Hepatology. 2017 Apr;65(4):1196-1205. (PMID: 27775821); Am J Gastroenterol. 2020 Oct;115(10):1642-1649. (PMID: 32530829); Clin Gastroenterol Hepatol. 2015 Jan;13(1):172-9. (PMID: 24813175); Hepatol Commun. 2023 Apr 26;7(5):. (PMID: 37102768); Clin Gastroenterol Hepatol. 2019 Mar;17(4):766-773. (PMID: 30056183) |
| Grant Information: | R01 CA212008 United States CA NCI NIH HHS; K23 AA031310 United States AA NIAAA NIH HHS; R01 CA222900 United States CA NCI NIH HHS; U01 CA230694 United States CA NCI NIH HHS; U01 AA026975 United States AA NIAAA NIH HHS |
| Contributed Indexing: | Keywords: Early Detection; Hepatocellular Carcinoma; Liver Cancer; Screening; Ultrasound |
| Substance Nomenclature: | 0 (alpha-Fetoproteins) |
| Entry Date(s): | Date Created: 20230813 Date Completed: 20240129 Latest Revision: 20250202 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11415236 |
| DOI: | 10.1016/j.cgh.2023.08.003 |
| PMID: | 37573986 |
| Database: | MEDLINE |
Journal Article