Background: An enhanced surveillance schedule has been proposed for cirrhotics with viral etiology, who are considered at extremely high-risk of hepatocellular carcinoma (HCC). Aims: We compared the 3- and 6-months surveillance interval, evaluating cancer stage at diagnosis and patient survival. Methods: Data of 777 HBV and HCV cirrhotic patients with HCC diagnosed under a 3-months (n = 109, 3MS group) or a 6-months (n = 668, 6MS group) surveillance were retrieved from the Italian Liver Cancer database. Survival in the 3MS group was considered as observed and adjusted for lead-time bias, and survival analysis was repeated after a propensity score matching. Results: The 3-months surveillance interval neither reduced the share of patients diagnosed outside the Milano criteria, nor increased their probability to receive curative treatments. The median survival of 6MS patients (55.0 months [45.9–64.0]) was not significantly different from the observed (47.0 months [35.0–58.9]; p = 0.43) and adjusted (44.9 months [33.4–56.4]; p = 0.30) survival of 3MS patients. A propensity score analysis confirmed the absence of a survival advantage for 3MS patients. Conclusions: A tightening of surveillance schedule does not increase the diagnosis of early-stage tumors, the feasibility of curative treatments and the survival. Therefore, we should maintain the 6-months interval in the surveillance of viral cirrhotics.

Surveillance for hepatocellular carcinoma with a 3-months interval in “extremely high-risk” patients does not further improve survival / Pelizzaro, F.; Peserico, G.; D'Elia, M.; Cazzagon, N.; Russo, F. P.; Vitale, A.; Giannini, E. G.; Piccinnu, M.; Rapaccini, G. L.; Di Marco, M.; Caturelli, E.; Zoli, M.; Sacco, R.; Cabibbo, G.; Marra, F.; Mega, A.; Morisco, F.; Gasbarrini, A.; Svegliati-Baroni, G.; Foschi, F. G.; Olivani, A.; Masotto, A.; Nardone, G.; Raimondo, G.; Azzaroli, F.; Vidili, G.; Oliveri, F.; Trevisani, F.; Farinati, F.; Biselli, M.; Caraceni, P.; Garuti, F.; Gramenzi, A.; Neri, A.; Santi, V.; Piscaglia, F.; Tovoli, F.; Granito, A.; Muratori, L.; Benevento, F.; Dajti, E.; Marasco, G.; Ravaioli, F.; Cappelli, A.; Golfieri, R.; Mosconi, C.; Renzulli, M.; Imondi, A.; Sartori, A.; Penzo, B.; Pinto, E.; Cela, E. M.; Facciorusso, A.; Cacciato, V.; Casagrande, E.; Moscatelli, A.; Pellegatta, G.; De Matthaeis, N.; Allegrini, G.; Lauria, V.; Ghittoni, G.; Pelecca, G.; Chegai, F.; Coratella, F.; Ortenzi, M.; Missale, G.; Inno, A.; Marchetti, F.; Busacca, A.; Camma, C.; Di Martino, V.; Rizzo, G. E. M.; Franze, M. S.; Saitta, C.; Sauchella, A.; Bevilacqua, V.; Borghi, A.; Casadei Gardini, A.; Conti, F.; Dall'Aglio, A. C.; Ercolani, G.; Mirici, F.; Campani, C.; Di Bonaventura, C.; Gitto, S.; Coccoli, P.; Malerba, A.; Guarino, M.; Brunetto, M.; Romagnoli, V.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 54:7(2022), pp. 927-936. [10.1016/j.dld.2021.08.025]

Surveillance for hepatocellular carcinoma with a 3-months interval in “extremely high-risk” patients does not further improve survival

Missale G.
Membro del Collaboration Group
;
2022-01-01

Abstract

Background: An enhanced surveillance schedule has been proposed for cirrhotics with viral etiology, who are considered at extremely high-risk of hepatocellular carcinoma (HCC). Aims: We compared the 3- and 6-months surveillance interval, evaluating cancer stage at diagnosis and patient survival. Methods: Data of 777 HBV and HCV cirrhotic patients with HCC diagnosed under a 3-months (n = 109, 3MS group) or a 6-months (n = 668, 6MS group) surveillance were retrieved from the Italian Liver Cancer database. Survival in the 3MS group was considered as observed and adjusted for lead-time bias, and survival analysis was repeated after a propensity score matching. Results: The 3-months surveillance interval neither reduced the share of patients diagnosed outside the Milano criteria, nor increased their probability to receive curative treatments. The median survival of 6MS patients (55.0 months [45.9–64.0]) was not significantly different from the observed (47.0 months [35.0–58.9]; p = 0.43) and adjusted (44.9 months [33.4–56.4]; p = 0.30) survival of 3MS patients. A propensity score analysis confirmed the absence of a survival advantage for 3MS patients. Conclusions: A tightening of surveillance schedule does not increase the diagnosis of early-stage tumors, the feasibility of curative treatments and the survival. Therefore, we should maintain the 6-months interval in the surveillance of viral cirrhotics.
2022
Surveillance for hepatocellular carcinoma with a 3-months interval in “extremely high-risk” patients does not further improve survival / Pelizzaro, F.; Peserico, G.; D'Elia, M.; Cazzagon, N.; Russo, F. P.; Vitale, A.; Giannini, E. G.; Piccinnu, M.; Rapaccini, G. L.; Di Marco, M.; Caturelli, E.; Zoli, M.; Sacco, R.; Cabibbo, G.; Marra, F.; Mega, A.; Morisco, F.; Gasbarrini, A.; Svegliati-Baroni, G.; Foschi, F. G.; Olivani, A.; Masotto, A.; Nardone, G.; Raimondo, G.; Azzaroli, F.; Vidili, G.; Oliveri, F.; Trevisani, F.; Farinati, F.; Biselli, M.; Caraceni, P.; Garuti, F.; Gramenzi, A.; Neri, A.; Santi, V.; Piscaglia, F.; Tovoli, F.; Granito, A.; Muratori, L.; Benevento, F.; Dajti, E.; Marasco, G.; Ravaioli, F.; Cappelli, A.; Golfieri, R.; Mosconi, C.; Renzulli, M.; Imondi, A.; Sartori, A.; Penzo, B.; Pinto, E.; Cela, E. M.; Facciorusso, A.; Cacciato, V.; Casagrande, E.; Moscatelli, A.; Pellegatta, G.; De Matthaeis, N.; Allegrini, G.; Lauria, V.; Ghittoni, G.; Pelecca, G.; Chegai, F.; Coratella, F.; Ortenzi, M.; Missale, G.; Inno, A.; Marchetti, F.; Busacca, A.; Camma, C.; Di Martino, V.; Rizzo, G. E. M.; Franze, M. S.; Saitta, C.; Sauchella, A.; Bevilacqua, V.; Borghi, A.; Casadei Gardini, A.; Conti, F.; Dall'Aglio, A. C.; Ercolani, G.; Mirici, F.; Campani, C.; Di Bonaventura, C.; Gitto, S.; Coccoli, P.; Malerba, A.; Guarino, M.; Brunetto, M.; Romagnoli, V.. - In: DIGESTIVE AND LIVER DISEASE. - ISSN 1590-8658. - 54:7(2022), pp. 927-936. [10.1016/j.dld.2021.08.025]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11381/2937171
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