Lang, Sonja, Martin, Anna, Kasper, Philipp, Schramm, Christoph, Kuetting, Fabian, Goeser, Tobias, Steffen, Hans-Michael and Demir, Muenevver (2020). Hepatocellular carcinoma surveillance with liver imaging is not associated with improved survival. Scand. J. Gastroenterol., 55 (2). S. 222 - 228. ABINGDON: TAYLOR & FRANCIS LTD. ISSN 1502-7708

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Abstract

Objective: International guidelines recommend hepatocellular carcinoma (HCC) surveillance with ultrasound in high-risk patients with chronic liver diseases. However, there is low-strength evidence about the effects on mortality. The aim of our study was to assess the impact of surveillance on the clinical course and survival of HCC patients seen at a tertiary referral center in Germany. Material and methods: We retrospectively evaluated the data of 401 HCC patients, who presented to our clinic between 1997 and 2015. Two groups were compared regarding patient and disease outcomes: one group included patients who received at least two ultrasound examinations for surveillance purposes prior to first diagnosis (n = 111). The other group consisted of patients with HCC at first presentation without foregoing HCC surveillance (n = 290). Results: Median follow-up in the surveillance group was 76 months (range 4-310 months). Patients in the surveillance group had smaller median tumor sizes (3.5 cm vs. 4.5 cm; p < .001), fulfilled more often Milan criteria (64% vs. 42%; p < .001) and received more often liver transplantation (27% vs. 9%, p < .001) when compared with the non-surveillance group. However, HCC surveillance was not associated with an improved survival (14 months in the surveillance group vs. 12 months in the non-surveillance group, p = .375), hazard ratio regarding overall mortality for the surveillance group: 0.80 (95% CI: 0.62-1.04, p = .09). Conclusions: HCC surveillance with ultrasound led to the detection of earlier disease stages but was not significantly associated with improved survival. Further prospective and long-term studies are needed to clarify benefits and harms of HCC surveillance programs on mortality.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Lang, SonjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Martin, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kasper, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schramm, ChristophUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuetting, FabianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goeser, TobiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steffen, Hans-MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Demir, MuenevverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-348227
DOI: 10.1080/00365521.2020.1718747
Journal or Publication Title: Scand. J. Gastroenterol.
Volume: 55
Number: 2
Page Range: S. 222 - 228
Date: 2020
Publisher: TAYLOR & FRANCIS LTD
Place of Publication: ABINGDON
ISSN: 1502-7708
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
RANDOMIZED CONTROLLED-TRIAL; CRYPTOGENIC CIRRHOSIS; DIAGNOSIS; TRANSPLANTATION; DISEASE; IMPACTMultiple languages
Gastroenterology & HepatologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/34822

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