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Incidence and risk factors for surveillance failure in patients with regular hepatocellular carcinoma surveillance.

Abstract：

BACKGROUND:Initial presentation of hepatocellular carcinoma (HCC) at an advanced stage in patients under a regular surveillance program is a devastating problem. AIMS:We assessed the prevalence and factors associated with this surveillance failure. METHODS:A total of 304 HCC patients who received regular surveillance were retrospectively reviewed. Surveillance failure was defined when the tumor was diagnosed at beyond the Milan criteria. RESULTS:Surveillance failure rate was 5.9 %. Macronodular cirrhosis (MC), ultrasonography-only surveillance (US-S) and infiltrative tumor type were independent factors associated with surveillance failure. The surveillance failure rate was higher in patients with MC (10.3 vs. 3.2 %, p = 0.022), US-S (14.6 vs. 4.3 %, p = 0.013) and when the tumor was infiltrative type (57.1 vs. 2.1 %, p < 0.001). Based on the two baseline factors (MC and US-S), the surveillance failure rates were 35.7, 6.8, 5.9 and 2.6 % for MC(+)/US-S(+), MC(+)/US-S(-), MC(-)/US-S(+) and MC(-)/US-S(-), respectively (p < 0.001). CONCLUSION:The HCC surveillance failure was not rare in clinical practice. These data suggest that special attention for surveillance failure might be needed for patients with MC who receive US-S.

journal_name

Hepatol Int

journal_title

Hepatology international

authors

Sinn DH,Yi J,Choi MS,Choi D,Gwak GY,Paik YH,Lee JH,Koh KC,Paik SW,Yoo BC

doi

10.1007/s12072-013-9462-z

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

1010-8

issue

4

eissn

1936-0533

issn

1936-0541

pii

10.1007/s12072-013-9462-z

journal_volume

7

pub_type

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