Limited utility of routine bone scintigraphy in the staging of patients with hepatocellular carcinoma: A cross-sectional study.

Autor:	Rodriguez-Alvarez F; Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan. Mexico City, CP 14080, Mexico; Liver Unit, Hospital Clinic, University of Barcelona, Barcelona, Spain. Street Villarroel, 170, L'Eixample, 08036 Barcelona, Spain; Faculty of Medicine and Health Sciences, Doctoral Program in Medicine and Translational Research, University of Barcelona, Barcelona, Spain. Street Casanova, 143, L'Eixample, 08036 Barcelona, Spain., Mota-Ayala BZ; Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan. Mexico City, CP 14080, Mexico., Villavicencio-Martínez R; Surgery Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan. Mexico City, CP 14080, Mexico., Kauffman-Ortega E; Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan. Mexico City, CP 14080, Mexico., Téllez-Morán LS; Radiology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan. Mexico City, CP 14080, Mexico., Castro-Narro G; Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan. Mexico City, CP 14080, Mexico., Ignacio-Alvarez E; Nuclear Medicine Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan. Mexico City, CP 14080, Mexico., Gabutti-Thomas JA; Radiology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan. Mexico City, CP 14080, Mexico., Moctezuma-Velazquez C; Gastroenterology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga 15, Belisario Domínguez Secc 16, Tlalpan. Mexico City, CP 14080, Mexico; Department of Medicine - Division of Gastroenterology (Liver Unit), University of Alberta. Edmonton, Alberta, Canada. 8540 112 Street NW, Zeidler Ledcor Centre, Room 1-20B, Edmonton, Alberta, T6G 2×8, Canada. Electronic address: moctezum@ualberta.ca.
Jazyk:	angličtina
Zdroj:	Annals of hepatology [Ann Hepatol] 2024 Aug 13; Vol. 29 (6), pp. 101545. Date of Electronic Publication: 2024 Aug 13.
DOI:	10.1016/j.aohep.2024.101545
Abstrakt:	Introduction and Objectives: The most widely used staging system for hepatocellular carcinoma (HCC) is the Barcelona Liver Clinic Cancer (BCLC) system, which considers tumor burden, performance status, and liver function. Tumor burden is assessed with cross sectional imaging of the abdomen and chest, controversy surrounds the routine use of bone scintigraphy (BS) for detecting extrahepatic metastases. This study evaluated the role of BS in staging HCC in Mexican patients. Patients and Methods: Retrospective cross-sectional study of all adults with HCC at a Mexican referral center from 2000 to 2018. Staging included abdominal computed tomography (CT) or magnetic resonance imaging, chest CT, and BS. The main outcome was the impact of BS on staging and/or therapy plans. Results: Among 238 patients, 2 with fibrolamellar variant and 44 with incomplete data were excluded. Median age was 66 years, 84 % had cirrhosis, and the predominant etiology was hepatitis C virus (43 %). BCLC stages were distributed as follows: A (14 %), B (7 %), C (68 %), and D (11 %). Extrahepatic disease was present in 18 %; only 8 % patients had a positive BS. Among the positive cases, 4 were true positives, but they did not alter staging or therapy plans. Conclusions: Routine BS in HCC staging demonstrated low yield, with a notable rate of false positives. Considering the implications of extrahepatic disease, BS may be justified for liver transplant candidates outside conventional criteria. Our study highlights the limited role of BS in early-stage HCC and advocates for a more selective utilization. Competing Interests: Conflicts of interest None. (Copyright © 2024 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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