Hepatocellular Carcinoma at a Tertiary Referral Center-experience with Surveillance in Patients at Risk Over 8 Years

Abstract

AIM: HCC surveillance is recommended for patients with liver cirrhosis. This study aimed to assess the impact of surveillance on the clinical course and survival in HCC patients. METHODS: Clinical data of 336 patients with liver cirrhosis were evaluated retrospectively. Patients were divided into 2 groups: group 1 included patients who did not suffer from HCC at initial contact and had at least 2 ultrasound examinations for surveillance purposes (n=161). Group 2 included patients with HCC at first presentation and without any foregoing HCC-surveillance (n=76). Groups were compared regarding patient and disease characteristics, liver transplantation and survival time. RESULTS: Men were significantly more often affected by HCC (p=0.005). The number needed to screen for one incident HCC was 7, and 81% of HCC cases were detected by ultrasound. There was no significant difference between groups 1 and 2 in the number of patients fulfilling Milan or UCSF criteria (45.8% in group 1 vs. 34.2% in group 2, and 50.0% in group 1 vs. 46.1% in group 2, respectively). Mean survival time of patients with incident HCC (group 1: 51.8 +/- 7.7 months) was not significantly different from patients with HCC at first presentation (group 2: 50.4 +/- 5.6 months). CONCLUSION: Our surveillance program proved to be efficient in terms of number needed to screen but did not result in a proven survival benefit for HCC patients. Strict adherence to regular observation intervals seems warranted in order to prove an impact of surveillance on long-term survival.