Features Partner Sites Information LinkXpress
Sign In
Advertise with Us
Ampronix

Hepatocellular Carcinoma Screening Linked with Curative Treatment and Longer Survival in Cirrhosis Patients

By Medimaging International staff writers
Posted on 24 Apr 2014
Print article
Image: Very high magnification micrograph of fibrolamellar hepatocellular carcinoma showing the characteristic laminated fibrosis between the tumor cells with a low N/C ratio. H&E stain (Photo courtesy of Wikimedia Commons).
Image: Very high magnification micrograph of fibrolamellar hepatocellular carcinoma showing the characteristic laminated fibrosis between the tumor cells with a low N/C ratio. H&E stain (Photo courtesy of Wikimedia Commons).
Investigators discovered that patients with cirrhosis who underwent surveillance (using liver ultrasound with or without measurement of serum alpha fetoprotein) for hepatocellular carcinoma (HCC) had cancers detected at an earlier stage, were more likely to receive curative instead of palliative treatment, and had longer survival.

In a systematic review and meta-analysis of 47 studies with 15,158 patients, Dr. Amit Singal, from the University of Texas Southwestern Medical Center (Dallas, USA) and colleagues reported that the pooled thee-year survival rate across all the studies was 50.8% among the 4,735 patients who underwent HCC surveillance, compared to 27.9% among the 6,115 patients without earlier surveillance (p < 0.001).

The finding of longer survival persisted after the authors limited their review to studies that took into account lead time bias. Lead time bias, as it applies to this study, is the time between when a disease would normally be diagnosed without screening and when the disease is diagnosed with screening. Detecting disease earlier through screening can at times seen be to increase survival when instead it only prolongs the time the person has the diagnosis. However, in this case, studies that accounted for lead time bias statistically still found that screening increased survival. Among the six studies that adjusted for lead time bias, those who underwent HCC surveillance had three-year survival rates of 39.7%, vs. 29.1% among those who did not (p < 0.001).

The authors noted that while screening for HCC in patients with Hepatitis B virus (HBV) infection is supported by a large randomized trial, no such randomized trials exist for patients with cirrhosis. Therefore the authors systematically reviewed published research that evaluated whether screening was associated with improved patient outcomes. While guidelines of the American Association for the Study of Liver Diseases and European Association for the Study of the Liver recommend monitoring with ultrasound every six months in high-risk patients (which includes those with chronic HBV infection and/or cirrhosis), the authors noted that studies have shown that surveillance in the United States is performed in less than 20% of these patients nationally, with lower rates among primary care physicians than gastroenterologists/hepatologists (physicians who specialize in caring for patients with liver disease).

A drawback of the study is that the studies were quite heterogeneous, suggesting benefits of surveillance may not be uniform among all patients, and studies did not include functional status, an important factor in determining appropriate treatment.

The authors concluded that, “the preponderance of data that consistently demonstrate benefits should provide sufficient rationale to recommend HCC surveillance, even in the absence of a randomized controlled trial among patients with cirrhosis.”

Related Links:

University of Texas Southwestern Medical Center



Print article
TeraRecon

Channels

Radiography

view channel

Surge in CT Scans for Patients with Minor Injuries

A new study reveals that almost twice as many patients with non-serious injuries are undergoing computerized tomography (CT) scans in the emergency department (ED) compared to a decade ago. Researchers at the University of California, San Francisco (UCSF; USA) and Stanford University (CA, USA) conducted a retrospective... Read more

MRI

view channel
Image: Correlated MR and UM stack 3 weeks after GL261 tumor implantation (Photo courtesy of eLife).

Imaging Toolkit Helps Identify Brain Tumor Drug Targets

A combined magnetic resonance imaging (MRI) and ultramicroscopy (UM) toolkit could help study vessel growth as an aid in glioblastoma therapies, according to a new study. Researchers at the University... Read more

Nuclear medicine

view channel
Image: The SiPM detector (Photo courtesy of Volkmar Schultz, Aachen University).

New Hybrid PET/MRI System Developed for Enhanced Breast Cancer Imaging

A novel imaging technique is being developed that can improve breast cancer detection and characterization, and help clinicians evaluate the response of the cancer to treatment. The 4-year project,... Read more

General/Advanced Imaging

view channel

Healthcare IT Manufacturer and Teleradiology Interoperability Expert Introduce New FHIR System

A new interoperability system that was launched at the 2015 Radiological Society of North America (RSNA) annual meeting in Chicago, USA, in November, 2015, is now being introduced into the market. The system enables seamless integration of third party enterprise imaging systems using the latest Fast Healthcare Interoperability... Read more

Imaging IT

view channel
Image: Photo of the virtual reality device mobile diagnostic imaging (Photo courtesy of RSNA).

Prototype of Virtual Reality Device with Potential for Diagnostic Imaging Presented

A prototype of a high-resolution mobile Virtual Reality (VR) diagnostic imaging device for radiologists was presented at the annual Radiological Society of North America (RSNA 2015) meeting in Chicago (IL, USA).... Read more

Industry News

view channel

Radiology Oncology Surgical Robot Devices Sector Could Reach USD 7.3 Billion by 2022

A new report has been published indicating that worldwide market for radiology oncology surgical robots market is growing mainly due to an aging world population, and the benefits the new technology can offer. Radiology oncology surgical robot technology provides opportunities to change cancer treatment methods, including... Read more
Copyright © 2000-2016 Globetech Media. All rights reserved.