Abstract:
AIM:To determine the incidence of hepatocellular carcinoma (HCC) and the impact of HCC surveillance on early diagnosis and survival of cirrhotic outpatients. METHODS:In this retrospective cohort study, cirrhotic outpatients undergoing HCC surveillance between March 2005 and March 2014 were analyzed. Exclusion criteria were HIV coinfection; previous organ transplantation; diagnosis of HCC at first consultation; missing data in the medical chart; and less than 1 year of follow-up. Surveillance was carried out every six months using ultrasound and serum alpha-fetoprotein determination. Ten-year cumulative incidence and survival were estimated through Kaplan-Meier analysis. RESULTS:Four hundred and fifty-three patients were enrolled, of which 57.6% were male. Mean age was 55 years. Hepatitis C virus and heavy use of alcohol were the main etiologic agents of cirrhosis. HCC was diagnosed in 75 patients (16.6%), with an estimated cumulative incidence of 2.6% in the 1st year, 15.4% in the 5th year, and 28.8% in the 10th year. Median survival was estimated at 17.6 mo in HCC patients compared to 234 mo in non-HCC patients (P < 0.001). Early-stage HCC was more often detected in patients who underwent surveillance every 6 mo or less (P = 0.05). However, survival was not different between patients with early stage vs non-early stage tumors [HR = 0.54 (0.15-1.89), P = 0.33]. CONCLUSION:HCC is a frequent complication in patients with cirrhosis and adherence to surveillance programs favors early diagnosis.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Appel-da-Silva MC,Miozzo SA,Dossin IA,Tovo CV,Branco F,de Mattos AAdoi
10.3748/wjg.v22.i46.10219subject
Has Abstractpub_date
2016-12-14 00:00:00pages
10219-10225issue
46eissn
1007-9327issn
2219-2840journal_volume
22pub_type
杂志文章abstract::One potential option for the management of refractory gastro-esophageal reflux disease (GERD) is the delivery of radiofrequency energy to the gastro-esophageal junction (Stretta). This endoscopic therapy is safe, effective, durable, and repeatable if necessary and serves an unmet need for many GERD sufferers. Stretta ...
journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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journal_title:World journal of gastroenterology
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,meta分析,评审
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