Imaging surveillance and multidisciplinary review improves curative therapy access and survival in HCC patients
Journal Title: Annals of Hepatology - Year 2013, Vol 12, Issue 5
Abstract
Introduction. Imaging surveillance and multidisciplinary conference (MDC) review can potentially improve survival in patients with hepatocellular carcinoma (HCC) by increasing access to liver transplantation. Geographic disparities in donor organ availability may reduce this benefit. This study evaluated the impact of HCC surveillance on use of curative therapies and survival in a region with long transplant waiting times.Material and methods. 167 HCC patients were retrospectively studied. Subjects had an established HCC diagnosis or were diagnosed during hepatology follow-up. Collected data included patient demographics, HCC surveillance and MDC review status, portal hypertension complications, laboratory and radiologic parameters, tumor size, therapeutic interventions, tumor progression, and mortality. The primary outcome measures were use of curative treatments and survival. A Cox-regression model was constructed utilizing factors associated with survival in univariate analysis.Results. 58% of subjects underwent surveillance and MDC review of HCC. These patients were more likely to have received treatment with ablation or resection (16 vs. 3%, P = 0.006) and transplantation (23 vs. 4%, P = 0.001), and were less likely to develop tumor progression (45 vs. 68%, P = 0.005) or metastases (0 vs. 19%, P < 0.001). In multivariate analysis, surveillance and MDC review (P = 0.034, HR 0.520, 95% CI 0.284-0.952), tumor meeting Milan criteria (P < 0.001, HR 0.329, 95%CI 0.178-0.607), curative therapy application (P = 0.048, HR 0.130, 95% CI 0.017-0.979), and transplantation (P = 0.004, HR 0.236, 95% CI 0.088-0.632) were associated with survival.Conclusion. In conclusion, imaging surveillance and MDC review is associated with detection of early stage HCC, increased access to curative therapies and transplantation, and prolonged survival.
Authors and Affiliations
Ron C. Gaba, Eric R. Kallwitz, Ahmad Parvinian, James T. Bui, Natasha M. Von Roenn, Jamie L. Berkes, Scott J. Cotler
Keywords
Related Articles
- EP ID EP78317
- DOI -
- Views 117
- Downloads 0
Direct Acting Antivirals Improve HCV Treatment Initiation and Adherence Among Underserved African Americans
Introduction. Adherence to hepatitis C (HCV) care was suboptimal in the interferon era among underserved African Americans (AA), but adherence data in the era of direct acting antivirals (DAA) is lacking in this populati...
Association between hepatitis B virus and chronic kidney disease: a systematic review and meta-analysis
Background. Hepatitis B virus infection and chronic kidney disease are prevalent and remain a major public health problem worldwide. It remains unclear how infection with hepatitis B virus impacts on the development and...
Hepatocellular adenoma: different entities for a single lesion
Latin American Association for the Study of the Liver Practice Guidelines Diagnosis, management, and treatment of hepatitis C This document has been approved by the Latin American Association for the Study of the Liver (ALEH)
Correlation of adipose tissue with liver histology in Asian Indian patients with nonalcoholic fatty liver disease (NAFLD)
Background. There is sparse literature on the association of adipose tissue with liver histology in patients with nonalcoholic fatty liver disease (NAFLD). Aim. To study the correlation of visceral adipose...