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

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



Channels

Radiography

view channel

Pediatric Radiation Dose Reduction Key Factor in Selection of DR Systems

X-Ray dose reduction potential was a key factor in the decision of the Washington DC (USA) metropolitan area Children’s National Health System to install new Direct Radiography (DR) systems. The priority of Children’s National Health System was to ensure that pediatric patients would receive the lowest possible dose... Read more

MRI

view channel
Image: The Micronor M303 Encoding Sensor with A/B Quadrature Pulse Train Background (Photo courtesy of Micronor).

World’s First MRI-Safe Linear Encoder for Medical Applications Announced

A company specialized in producing fiber optic kinetic sensors, has developed a first-of-a-kind passive, optical, non-electronic, high-precision encoder for use in medical Magnetic Resonance Imaging (MRI).... Read more

Nuclear medicine

view channel

Hybrid Scanner Using Five Molecular Imaging Techniques Under Development

Scientists are developing a new molecular, preclinical hybrid imaging system to help find new drugs and to advance imaging research. The scanner was presented at the 2015 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI; Reston, Virginia, USA), and consists of a window for tissue observation,... Read more

General/Advanced Imaging

view channel

FDA Approves Trial for Intraoperative Image-Guided Cancer Surgery System

The US Food and Drug Administration (FDA) has provided Investigational Device Exemption (IDE) approval for company to trial a new image-guided cancer surgery system for intraoperative imaging of breast cancer. The surgical system consists of a cancer-specific molecular imaging agent, and a lightweight hand-held single-cell... Read more

Imaging IT

view channel
Image: Siemens radiation therapy Syngo.via image suite (Photo courtesy of Siemens Healthcare).

New Version of Syngo.via Supports Treatment Decision in Oncology

Siemens Healthcare has released a new version of oncology diagnostics software that helps physicians plan the best course of treatment for cancer patients. Cancer treatment requires comprehensive diagnostics,... Read more

Industry News

view channel
Image: The Westchester Medical Center in Valhalla, NY, USA (Photo courtesy of Business Wire).

Philips to Provide Multi-Year USD 500 Million in Healthcare Services in the USA

Royal Philips (Amsterdam, the Netherlands) and the Westchester Medical Center Health Network (WMCHealth; Valhalla, NY, USA) have announced USD 500 million multi-year partnership. Philips will provide... Read more
 
Copyright © 2000-2015 Globetech Media. All rights reserved.