Hepatocellular Carcinoma Surveillance—Experience from Croatian Referral Centre for Chronic Liver Diseases
| Autor: | Matea Majerović, Davor Radić, Mislav Jelaković, Zeljko Krznaric, Marina Premužić, Ivana Knežević Štromar, Stjepko Pleština, Rajko Ostojić, Nadan Rustemović, Marko Mance |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular Croatia medicine.medical_treatment Newly diagnosed Chronic liver disease Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Stage (cooking) Aged Retrospective Studies Ultrasonography business.industry Liver Diseases Liver Neoplasms Retrospective cohort study medicine.disease BCLC Stage Radiation therapy Oncology 030220 oncology & carcinogenesis Hepatocellular carcinoma Population Surveillance Referral centre Chronic Disease 030211 gastroenterology & hepatology Female business Surveillance |
| DOI: | 10.1007/s12029-017-0011-1 |
| Popis: | PURPOSE: For patients at high-risk of developing hepatocellular carcinoma (HCC), biannual ultrasound surveillance has long been recommended, in order to detect the tumor in the early, potentially curative stages. However, globally reported HCC surveillance rates vary greatly, ranging from as low as 1.7 to as high as 80%. Our aim was to assess the utilization of surveillance with biannual ultrasound in high-risk Croatian patients and to identify the factors that impact the implementation of the recommended protocol. METHODS: This retrospective study included 145 newly diagnosed HCC patients in the period from January 2010 to September 2015. We identified low-risk and high-risk patients. The latter were further subdivided into the regular biannual ultrasound surveillance group and the non-surveillance group. The groups were compared according to demographic characteristics and BCLC stage at the time of HCC diagnosis. RESULTS: Among 145 patients, 80 patients were classified as high-risk according to EASL criteria. During the relevant period, 28.7% underwent regular surveillance, while 71.25% did not. Younger patients were more likely to undergo surveillance (OR 0.935 CI 0.874-0.999 ; p = 0.05). The patients who underwent regular surveillance had a higher chance of being diagnosed at a curative stage (BCLC 0 or A) (OR 3.701 CI 1.279-10.710 ; p < 0.05).Gender was not a predictor of participation in the regular surveillance protocol. Among the high-risk patients who did not undergo regular surveillance, 56.1% were not aware of the chronic liver disease prior to the HCC diagnosis. CONCLUSION: HCC surveillance is still underutilized in high-risk Croatian patients despite its obvious benefits possibly due to the untimely diagnosis of the chronic liver disease. |
| Databáze: | OpenAIRE |
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