Is bone scintigraphy indicated in surgical work-up for hepatocellular carcinoma patients?
| Autor: | Dik J. Kwekkeboom, Caroline D.M. Witjes, Robert A. de Man, Roy S. Dwarkasing, Cornelis Verhoef, Jan N. M. IJzermans |
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| Přispěvatelé: | Surgery, Radiology & Nuclear Medicine, Gastroenterology & Hepatology |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Carcinoma Hepatocellular Adolescent Bone Neoplasms Asymptomatic Resection Young Adult Preoperative Care medicine Hepatectomy Humans In patient Child Radionuclide Imaging Aged Netherlands Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Liver Neoplasms Infant Health Care Costs Middle Aged medicine.disease Survival Analysis Work-up Treatment Outcome Skeletal bone Bone scintigraphy Hepatocellular carcinoma Child Preschool Asymptomatic Diseases Referral center Surgery Female Radiology medicine.symptom Neoplasm Recurrence Local business Follow-Up Studies |
| Zdroj: | Journal of Surgical Research, 181(2), 256-261. Academic Press |
| ISSN: | 0022-4804 |
| Popis: | Background Patients with hepatocellular carcinoma (HCC) undergo extensive staging investigations when being assessed for surgical resection. The aim of this study was to assess the use and yield of baseline bone scintigraphy in patients with HCC necessitating high-risk surgical resection. Material and methods All patients diagnosed with HCC between 2000 and 2010 within a tertiary referral center were reviewed. Recurrence and survival rates were compared between patients with and without bone scintigraphy in their preoperative work-up. Results A total of 366 patients were diagnosed with resectable HCC. In the work-up for resection 137 HCC patients (41%) underwent bone scintigraphy, which showed bone metastases in 3 (2%). There was no significant difference in long-term survival between patients with and without bone scintigraphy. None of the patients with a positive bone scintigraphy died due to skeletal bone metastases. Only one patient had an indication for bone scintigraphy based on clinical suspicion. Two patients were found to have asymptomatic skeletal metastases prior to surgery. Symptomatic skeletal metastases were identified at an estimated cost of €27,008 per case. Conclusions Clinically unsuspicious bone lesions turned out to be metastases in two patients, with an estimated cost of €27,008 per case. Recurrence rate and disease-free and overall survival showed no significant difference between patients with and without preoperative baseline bone scintigraphy. There is no justification for routine preoperative bone scintigraphy to detect asymptomatic skeletal metastases in patients with resectable HCC. |
| Databáze: | OpenAIRE |
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