TY - JOUR
T1 - Failure in all steps of hepatocellular carcinoma surveillance process is frequent in daily practice
AU - Dirchwolf, Melisa
AU - Marciano, Sebastián
AU - Ruf, Andres E.
AU - Singal, Amit G.
AU - D'Ercole, Vanina
AU - Coisson, Paola
AU - Zerega, Alina
AU - Orozco, Federico
AU - Palazzo, Ana
AU - Fassio, Eduardo
AU - Arufe, Diego
AU - Anders, Margarita
AU - D'Amico, Claudia
AU - Gaite, Luis
AU - Thompson, Marcos
AU - Perez, Daniela
AU - Haddad, Leila
AU - Demirdjian, Ezequiel
AU - Zunino, Moira
AU - Gadano, Adrián
AU - Murga, María Dolores
AU - Bermudez, Carla
AU - Tomatis, Jesica
AU - Grigera, Nadia
AU - Antinucci, Florencia
AU - Baravalle, Manuel
AU - Gazari, Maria Mercedes Rodriguez
AU - Ferreiro, Melina
AU - Barbero, Manuel
AU - Curia, Andrea
AU - Demonte, Manuel
AU - Gualano, Gisela
N1 - Funding Information:
This study was awarded with a scholarship from the Sociedad Argentina de Hepatolog?a (S.A.H.E).
Publisher Copyright:
© 2021 Fundación Clínica Médica Sur, A.C.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - 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.
AB - 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.
KW - Alpha fetoprotein
KW - Cirrhosis
KW - Failure
KW - Liver cancer
KW - Screening
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U2 - 10.1016/j.aohep.2021.100344
DO - 10.1016/j.aohep.2021.100344
M3 - Article
C2 - 33819695
AN - SCOPUS:85103932965
SN - 1665-2681
VL - 25
JO - Annals of Hepatology
JF - Annals of Hepatology
M1 - 100344
ER -