Features | Partner Sites | Information | LinkXpress
Sign In
GLOBETECH PUBLISHING LLC
Ampronix
Schiller

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

By Medimaging International staff writers
Posted on 24 Apr 2014
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



Supersonic Imagine
ARAB HEALTH
PCI Precision Charts

Channels

Radiography

view channel
Image: This shows a 3D print model used in surgical planning (Photo courtyes of RSNA).

3D Printing and CT Imaging Used to Guide Human Face Transplants

Surgeons are using computed tomography (CT) imaging and three-dimensional (3-D) printing technology to reconstruct life-size models of patients’ heads to help better control the outcome in face transplantation... Read more

MRI

view channel
Image: Head impact telemetry system (HITs) helmet-mounted accelerometers are used in youth and collegiate football to evaluate the frequency and severity of helmet impacts (Photo courtesy of RSNA).

DTI-MRI Shows Brain Alterations in High School Football Players After Only One Season

Some high school football players exhibit measurable brain alterations after only one season of play, even in the absence of concussion. The new findings were presented at the annual meeting of the... Read more

General/Advanced Imaging

view channel
Image: The DermSpectra total body digital skin imaging system (Photo courtesy of DermSpectra).

Total Body Digital Skin Imaging System Developed for Dermatology and Primary Care Practices

A total body digital skin imaging system enables physicians to track critical skin changes (skin cancers, eczema, lesions, psoriasis, and rashes) in their office, over time. The DermSpectra (Tucson,... Read more

Imaging IT

view channel
Image: The DCMSYS Interface WebBridge is designed to connect to DCMSYS product range to access all the patient data, search studies, link data to the appropriate study and store, modify, share, and connect to any repository (Photo courtesy of Dicom Systems).

WebBridge Software for Medical Facilities Allows Third-Party Interfaces to Develop Front-End Functionality in a Matter of Days

Designed for medical facilities of any size, new web software allows any native or web-based third-party application to upload any non-standard data (e.g., JPEG, TFF, PDF, TXT, etc.) to an enterprise imaging... Read more

Industry News

view channel

X-Ray and Digital X-Ray Sector Nears USD 8 Billion in 2014

The market for both traditional and digital X-ray systems is estimated to reach USD 7.9 billion in 2014, according to a recent report from an international market research company. The healthcare market research publisher noted that upgrades of existing equipment and the rising incidence of disease are fueling the market.... Read more
 
Copyright © 2000-2014 Globetech Media. All rights reserved.