Failure in all steps of hepatocellular carcinoma surveillance process is frequent in daily practice

Melisa Dirchwolf, Sebastián Marciano, Andres E. Ruf, Amit G. Singal, Vanina D'Ercole, Paola Coisson, Alina Zerega, Federico Orozco, Ana Palazzo, Eduardo Fassio, Diego Arufe, Margarita Anders, Claudia D'Amico, Luis Gaite, Marcos Thompson, Daniela Perez, Leila Haddad, Ezequiel Demirdjian, Moira Zunino, Adrián GadanoMaría Dolores Murga, Carla Bermudez, Jesica Tomatis, Nadia Grigera, Florencia Antinucci, Manuel Baravalle, Maria Mercedes Rodriguez Gazari, Melina Ferreiro, Manuel Barbero, Andrea Curia, Manuel Demonte, Gisela Gualano

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction and objectives: Failures at any step in the hepatocellular carcinoma (HCC) surveillance process can result in HCC diagnostic delays and associated worse prognosis. We aimed to estimate the prevalence of surveillance failure and its associated risk factors in patients with HCC in Argentina, considering three steps: 1) recognition of at-risk patients, 2) implementation of HCC surveillance, 3) success of HCC surveillance. Methods: We performed a multi-center cross-sectional study of patients at-risk for HCC in Argentina seen between10.01.2018 and 10.30.2019. Multivariable logistic regression analysis was used to identify correlates of surveillance failure. Results: Of 301 included patients, the majority were male (74.8%) with a mean age of 64 years old. At the time of HCC diagnosis, 75 (25%) patients were unaware of their diagnosis of chronic liver disease, and only 130 (43%) patients were under HCC surveillance. Receipt of HCC surveillance was significantly associated with follow-up by a hepatologist. Of 119 patients with complete surveillance, surveillance failure occurred in 30 (25%) patients. Surveillance failure was significantly associated with alpha fetoprotein ≥20 ng/mL (OR 4.0, CI 95% 1.43−11.55). Conclusions: HCC surveillance failure was frequent in all the evaluated steps. These data should help guide strategies to improve the implementation and results of HCC surveillance in our country.

Original languageEnglish (US)
Article number100344
JournalAnnals of Hepatology
Volume25
DOIs
StatePublished - Nov 1 2021

Keywords

  • Alpha fetoprotein
  • Cirrhosis
  • Failure
  • Liver cancer
  • Screening

ASJC Scopus subject areas

  • Hepatology

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