Effect of surveillance for hepatocellular carcinoma on tumor staging and treatment decisions in Egyptian patients

Abstract

Purpose Egyptian hepatocellular carcinoma (HCC) patients present at advanced stages. We aimed to study the influence of surveillance versus non-surveillance on HCC staging and the potential therapeutic options. Methods A retrospective study to evaluate the effect of surveillance on early detection of HCC among cirrhotic patients from 2003 to 2008. Patients examined every 6 months using ultrasound and a-fetoprotein (a-FP) (group A) and those diagnosed with those that present for the first time symptomatically or incidentally (group B). Groups were compared for a-FP level, tumour characteristics, severity of liver disease; tumour staging was evaluated by Okuda, CLIP and BCLC staging systems, in addition to the potential therapeutic options. Results Group A comprised 122 HCC cases and group B 473. Surveillance improved HCC detection: at the stage of single nodule in 62.3% in group A versus 52.2% in group B, (P = 0.046) and reduced the percentage of HCC with portal vein thrombosis in 16.4 versus 33.8%, (P = 0.000) and the percentage of a-FP [400 ng/ml in 19.5 versus 32.6%, (P = 0.006) in groups A and B, respectively. Surveillance doubled the detection of HCC at early stage of BCLC (25.4 vs. 11.9% P = 0.000) and doubled the patients' chance for loco-regional ablation (12.3 vs. 5.9%, P = 0.015) and liver transplantation (10.7 vs. 3.2%, P = 0.001) in groups A and B, respectively. Conclusion HCC surveillance increases early detection of HCC and doubled the chances for curative options. Implementation of both HCC surveillance and cadaveric liver transplantation programs should be recommended in Egypt.

Osteopontin as A Tumor Marker for Hepatocellular Carcinoma

“…But the frequency of elevated AFP did not differ with regards to MELD score or cirrhotic disease [36] . But there was significant positive correlation between AFP and CLIP, Tokyo, and VISUM staging system among HCC cases, these were in agreement with El-Shenawy et al [29] and El-Zayadi et al [37] who reported that there was significant positive correlation between AFP and CLIP staging systems.…”

Plasma Osteopontin as a Novel Diagnostic Biomarker for Early Detection of Hepatocellular Carcinoma.

“…Discussion:-HCC is the most common malignancy in Egypt, where there is the high prevalence of HCV infection all over the world. In Egypt, about 14% of the population has chronic HCV infection [17]. The delayed diagnosis of HCC leads to poor response to treatment.…”

The Impact of National Surveillance for Liver Cancer: Results from Real-World Setting in Korea

“…Therefore, in the current study, we investigated the survival outcome of LC patients who received the surveillance program from the time it was implemented in South Korea. The mortality risk of patients who underwent the surveillance pro- 20 and had a better overall survival than those without surveillance. 18,[20][21][22] The time of survival was calculated from the point of HCC diagnosis.…”

“…The mortality risk of patients who underwent the surveillance pro- 20 and had a better overall survival than those without surveillance. 18,[20][21][22] The time of survival was calculated from the point of HCC diagnosis. Data were censored at the date of death or last day of follow-up.…”