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HCC surveillance results in earlier HCC detection: results from an Indian cohort

Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death worldwide, with an increased incidence in South Asia. In order to describe the effect of surveillance for HCC with biannual ultrasound and alpha-fetoprotein (AFP) on diagnosis and survival in an Indian population a...

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Autores principales: Kohli, Anita, Murphy, Allison A, Agarwal, Chirdeep, Shivakumar, Bhavana, Kottilil, Shyam, Polis, Michael A, Subramanian, G Mani, Midha, Vandana, Goyal, Omesh, Desai, Srinivas, Sood, Ajit, Shah, Samir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209002/
https://www.ncbi.nlm.nih.gov/pubmed/25392781
http://dx.doi.org/10.1186/2193-1801-3-610
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author Kohli, Anita
Murphy, Allison A
Agarwal, Chirdeep
Shivakumar, Bhavana
Kottilil, Shyam
Polis, Michael A
Subramanian, G Mani
Midha, Vandana
Goyal, Omesh
Desai, Srinivas
Sood, Ajit
Shah, Samir
author_facet Kohli, Anita
Murphy, Allison A
Agarwal, Chirdeep
Shivakumar, Bhavana
Kottilil, Shyam
Polis, Michael A
Subramanian, G Mani
Midha, Vandana
Goyal, Omesh
Desai, Srinivas
Sood, Ajit
Shah, Samir
author_sort Kohli, Anita
collection PubMed
description Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death worldwide, with an increased incidence in South Asia. In order to describe the effect of surveillance for HCC with biannual ultrasound and alpha-fetoprotein (AFP) on diagnosis and survival in an Indian population a retrospective cohort-control study was performed at two liver clinics in India. The medical records of 3,258 patients with cirrhosis who received surveillance for HCC were reviewed, and 100 patients who developed HCC identified. Sixty-four cirrhotic patients diagnosed with HCC during the same time period without a history of surveillance were included and survival, BCLC stage at diagnosis, and treatment were compared. Patients who underwent surveillance were more likely to be diagnosed with potentially curable or treatable BCLC Stage 0/A disease and Stage B/C disease respectively, than late Stage D disease (χ2 = 0.0007). Patients diagnosed at an earlier stage of HCC lived significantly longer after diagnosis than patients diagnosed at a later stage (Stage 0/A: 15.6 ± 14.2 months vs. Stage B/C: 9.43 ± 19.7 months vs. Stage D: 5.59 ± 11.9 months; p = 0.0006). While treatment for HCC improved overall survival, only 28% of eligible patients received treatment, explaining the lack of survival benefit noted in the surveillance group. Surveillance for HCC led to detection of HCC at earlier stages. The impact of surveillance on improved mortality could not be evaluated given the limited number of patients who received treatment. HCC surveillance has the potential to improve survival in South Asian patients with cirrhosis only if improvements in access to appropriate treatment are made.
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spelling pubmed-42090022014-11-12 HCC surveillance results in earlier HCC detection: results from an Indian cohort Kohli, Anita Murphy, Allison A Agarwal, Chirdeep Shivakumar, Bhavana Kottilil, Shyam Polis, Michael A Subramanian, G Mani Midha, Vandana Goyal, Omesh Desai, Srinivas Sood, Ajit Shah, Samir Springerplus Research Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related death worldwide, with an increased incidence in South Asia. In order to describe the effect of surveillance for HCC with biannual ultrasound and alpha-fetoprotein (AFP) on diagnosis and survival in an Indian population a retrospective cohort-control study was performed at two liver clinics in India. The medical records of 3,258 patients with cirrhosis who received surveillance for HCC were reviewed, and 100 patients who developed HCC identified. Sixty-four cirrhotic patients diagnosed with HCC during the same time period without a history of surveillance were included and survival, BCLC stage at diagnosis, and treatment were compared. Patients who underwent surveillance were more likely to be diagnosed with potentially curable or treatable BCLC Stage 0/A disease and Stage B/C disease respectively, than late Stage D disease (χ2 = 0.0007). Patients diagnosed at an earlier stage of HCC lived significantly longer after diagnosis than patients diagnosed at a later stage (Stage 0/A: 15.6 ± 14.2 months vs. Stage B/C: 9.43 ± 19.7 months vs. Stage D: 5.59 ± 11.9 months; p = 0.0006). While treatment for HCC improved overall survival, only 28% of eligible patients received treatment, explaining the lack of survival benefit noted in the surveillance group. Surveillance for HCC led to detection of HCC at earlier stages. The impact of surveillance on improved mortality could not be evaluated given the limited number of patients who received treatment. HCC surveillance has the potential to improve survival in South Asian patients with cirrhosis only if improvements in access to appropriate treatment are made. Springer International Publishing 2014-10-17 /pmc/articles/PMC4209002/ /pubmed/25392781 http://dx.doi.org/10.1186/2193-1801-3-610 Text en © Kohli et al.; licensee Springer. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.
spellingShingle Research
Kohli, Anita
Murphy, Allison A
Agarwal, Chirdeep
Shivakumar, Bhavana
Kottilil, Shyam
Polis, Michael A
Subramanian, G Mani
Midha, Vandana
Goyal, Omesh
Desai, Srinivas
Sood, Ajit
Shah, Samir
HCC surveillance results in earlier HCC detection: results from an Indian cohort
title HCC surveillance results in earlier HCC detection: results from an Indian cohort
title_full HCC surveillance results in earlier HCC detection: results from an Indian cohort
title_fullStr HCC surveillance results in earlier HCC detection: results from an Indian cohort
title_full_unstemmed HCC surveillance results in earlier HCC detection: results from an Indian cohort
title_short HCC surveillance results in earlier HCC detection: results from an Indian cohort
title_sort hcc surveillance results in earlier hcc detection: results from an indian cohort
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4209002/
https://www.ncbi.nlm.nih.gov/pubmed/25392781
http://dx.doi.org/10.1186/2193-1801-3-610
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