The DOI matches its Crossref record; 26 of the 26 references it cites were found in a registry or an index.
Semiannual and annual surveillance of cirrhotic patients for hepatocellular carcinoma: effects on cancer stage and patient survival (Italian experience)
Open accessAbstract
OBJECTIVES: Surveillance of cirrhotic patients for early detection of hepatocellular carcinoma, based on ultrasonography and alpha1-fetoprotein determination, is a recommended practice. However, it has not been proved that this procedure can improve patient survival. METHODS: We conducted a multicenter retrospective study on 1051 consecutive patients with hepatocellular carcinoma. The criteria for eligibility were presence of underlying cirrhosis, and description of cancer stage and modalities of its diagnosis. Among 821 patients fulfilling these criteria, the tumor was detected during semiannual surveillance in 215 individuals (group 1), during annual surveillance in 155 (group 2), and as a result of symptoms or incidentally in 451 (group 3). Survival of patients under surveillance was corrected for lead time. RESULTS: Cancer stage was similar in groups 1 and 2 and was less advanced than in group 3 (p < 0.001). The frequency of ablative treatments or chemoembolization was similar in groups 1 and 2 and was greater than in group 3 (p < 0.001). Both surveillance programs doubled the prevalence of potential candidates for liver transplantation (68.5% and 62.5%) with respect to group 3 (32.3%, p < 0.001). However, only 15 patients underwent transplantation. In groups 1 and 2, the 5-yr survival was equivalent and was greater than in group 3 (p < 0.001). By segregating patients according to severity of cirrhosis, the benefit was confined to compensated cirrhosis (adjusted relative risk of death for patients under surveillance: 0.59 [95% CI = 0.45-0.78]). CONCLUSIONS: Semiannual and annual surveillance equally improve the survival of cirrhotic patients with hepatocellular carcinoma and greatly increase the amenability rate to liver transplantation. When access to liver transplantation is limited, this benefit is restricted to patients with a good cirrhosis-related prognosis.
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Cited by
EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
Galle, P. R., Forner, A., Llovet, J. M., Mazzaferro, V., Piscaglia, F., Raoul, J.-L., Schirmacher, P., & Vilgrain, V. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2018.03.019 · Cited by 11,406
EASL–EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma
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“On the other hand, cohort comparisons of 6 versus 12-month schemes provide similar results [52,92], while retrospective studies identified better performance of the 6-month interval in terms of stage migration (small HCC amenable for curative treatments) [96] and survival [97].”
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Singal, A. G., Pillai, A., & Tiro, J. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001624 · Cited by 817
Hepatocellular Carcinoma From Epidemiology to Prevention: Translating Knowledge into Practice
Singal, A. G., & El-Serag, H. B. (2015) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2015.08.014 · Cited by 530
Metadata
- Authors
- Trevisani, F.
- Venue
- The American Journal of Gastroenterology
- Published
- 2002-03
- Volume
- 97
- Issue
- 3
- Pages
- 734-744
- ISSN
- 0002-9270 (ISSN-L)
- OpenAlex
- W2060544062
- Cited by
- 313
- References
- 26
- FWCI
- 5.88
- Type
- journal article
- Language
- en
- Open access
- green
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- Trevisani, F. (2002). Semiannual and annual surveillance of cirrhotic patients for hepatocellular carcinoma: effects on cancer stage and patient survival (Italian experience). The American Journal of Gastroenterology. https://doi.org/10.1016/s0002-9270(01)04119-3
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