Surveillance for Hepatocellular Carcinoma: Does the Place Where Ultrasound Is Performed Impact Its Effectiveness?

PIÑERO, FEDERICO; RUBINSTEIN, FERNANDO; MARCIANO, SEBASTIÁN; FERNÁNDEZ, NORA; ANDERS, MARGARITA; BERMÚDEZ, CARLA; MCCORMACK, LUCAS; GADANO, ADRIÁN; SILVA, MARCELO

DIGESTIVE DISEASE AND SCIENCES

SPRINGER

Lugar: Berlin; Año: 2018 vol. 64 p. 718 - 728

0163-2116

AbstractBackground Biannual ultrasound (US) is recommended as the clinical screening tool for hepatocellular carcinoma (HCC).The efectiveness of surveillance according to the place where US is performed has not been previously reported.Aims To compare the efectiveness of US performed in the center responsible for follow-up as opposed to US proceedingfrom centers other than that of follow-up.Methods This is a multicenter cohort study from Argentina. The last US was categorized as done in the same center or donein a diferent center from the institution of the patient?s follow-up. Surveillance failure was defned as HCC diagnosis notmeeting Barcelona Clinic Liver Cancer (BCLC) stages 0-A or when no nodules were observed at HCC diagnosis.Results From 533 patients with HCC, 62.4% were under routine surveillance with a surveillance failure of 38.8%. Afteradjusting for a propensity score matching, BCLC stage and lead-time survival bias, surveillance was associated with asignifcant survival beneft [HR of 0.51 (CI 0.38; 0.69)]. Among patients under routine surveillance (n=345), last US wasperformed in the same center in 51.6% and in a diferent center in 48.4%. Similar rates of surveillance failure were observedbetween US done in the same or in a diferent center (32% vs. 26.3%; P=0.25). Survival was not signifcantly diferentbetween both surveillance modalities [HR 0.79 (CI 0.53; 1.20)].Conclusions Routine surveillance for HCC in the daily practice improved survival either when performed in the same centeror in a diferent center from that of patient?s follow-up.