Hepatocellular carcinoma tumour volume doubling time: a systematic review and meta-analysis
| Autor: | Nicole E. Rich, Purva Gopal, Amit G. Singal, Binu John, Adam C. Yopp, Piyush Nathani, Neehar D. Parikh, Takeshi Yokoo, Jorge A. Marrero |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Oncology
Hepatitis medicine.medical_specialty Carcinoma Hepatocellular Time Factors business.industry Liver Neoplasms Gastroenterology Subgroup analysis Hepatitis B medicine.disease Article Tumor Burden Systematic review Internal medicine Meta-analysis Hepatocellular carcinoma medicine Etiology Disease Progression Doubling time Humans business |
| Zdroj: | Gut |
| ISSN: | 1468-3288 |
| Popis: | BackgroundTumour growth patterns have important implications for surveillance intervals, prognostication and treatment decisions but have not been well described for hepatocellular carcinoma (HCC). The aim of our study was to characterise HCC doubling time and identify correlates for indolent and rapid growth patterns.MethodsWe performed a systematic literature review of Medline and EMBASE databases from inception to December 2019 and national meeting abstracts from 2010 to 2018. We identified studies reporting HCC tumour growth or tumour volume doubling time (TVDT), without intervening treatment, and abstracted data to calculate TVDT and correlates of growth patterns (rapid defined as TVDT 9 months). Pooled TVDT was calculated using a random-effects model.ResultsWe identified 20 studies, including 1374 HCC lesions in 1334 patients. The pooled TVDT was 4.6 months (95% CI 3.9 to 5.3 months I2=94%), with 35% classified as rapid, 27.4% intermediate and 37.6% indolent growth. In subgroup analysis, studies from Asia reported shorter TVDT than studies elsewhere (4.1 vs 5.8 months). The most consistent correlates of rapid tumour growth included hepatitis B aetiology, smaller tumour size (continuous), alpha fetoprotein doubling time and poor tumour differentiation. Studies were limited by small sample sizes, measurement bias and selection bias.ConclusionTVDT of HCC is approximately 4–5 months; however, there is heterogeneity in tumour growth patterns, including more aggressive patterns in Asian hepatitis B-predominant populations. Identifying correlates of tumour growth patterns is important to better individualise HCC prognostication and treatment decisions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|