Risk of Hepatocellular Carcinoma in Subcentimeter Liver Nodules Identified on Surveillance Ultrasound: A Systematic Review.
| Title: | Risk of Hepatocellular Carcinoma in Subcentimeter Liver Nodules Identified on Surveillance Ultrasound: A Systematic Review. |
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| Authors: | Koo E; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Seif El Dahan K; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Daher D; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Rich NE; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Mittal S; Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas.; Yang JD; Department of Internal Medicine, Cedars Sinai, Los Angeles, California.; Parikh ND; Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan.; 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] 2025 Jul; Vol. 23 (8), pp. 1320-1327.e2. Date of Electronic Publication: 2024 Oct 29. |
| Publication Type: | Journal Article; Systematic Review |
| 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*/epidemiology ; Carcinoma, Hepatocellular*/diagnostic imaging ; Carcinoma, Hepatocellular*/pathology ; Liver Neoplasms*/diagnostic imaging ; Liver Neoplasms*/epidemiology ; Liver Neoplasms*/pathology; Ultrasonography/methods ; Liver Cirrhosis/complications ; Liver/diagnostic imaging ; Liver/pathology ; Humans ; Male ; Risk Factors ; Female ; Middle Aged ; Incidence |
| Abstract: | Background & Aims: Guidelines recommend that sub-centimeter nodules on ultrasound be followed with short-interval surveillance ultrasound, given assumed low risk of hepatocellular carcinoma (HCC) and suboptimal diagnostic imaging performance in lesions 90%). Among 2 studies with study periods post-dating 2015, HCC developed in only ∼5% of patients during a median follow-up of 2 years. Risk factors associated with incident HCC were older age, male sex, elevated alpha-fetoprotein levels, thrombocytopenia, and Child Pugh B cirrhosis. Limitations of studies included small sample sizes, selection bias, ascertainment bias for HCC, and failure to report factors associated with HCC.; Conclusion: Up to one-fifth of patients with sub-centimeter nodules may develop HCC, although contemporary cohorts report a substantially lower risk. Older patients and those with elevated alpha-fetoprotein levels or poorer liver function are at greatest risk of HCC, highlighting an unmet need for better risk stratification models.; (Copyright © 2025 AGA Institute. Published by Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: Cirrhosis; Indeterminate Findings; Liver Cancer; Screening; Ultrasound |
| Entry Date(s): | Date Created: 20241031 Date Completed: 20250625 Latest Revision: 20250711 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.cgh.2024.08.051 |
| PMID: | 39481466 |
| Database: | MEDLINE |
Journal Article; Systematic Review