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HCC surveillance resulted in earlier tumor detection, longer survival, curative rates for cirrhotic patients

Patients with cirrhosis who underwent surveillance for hepatocellular carcinoma had earlier tumor detection rates, a longer rate of survival and were more likely to receive curative vs. palliative treatment, according to results from a meta-analysis.

Researchers at the University of Texas Southwestern Medical Center performed a systematic literature review using Medline from January 1989 to January 2014, and included 47 studies with 15,158 patients. Hepatocellular carcinoma (HCC) was detected in 41.4% of patients using liver ultrasound surveillance, regardless of alpha fetoprotein levels, and led to improvements in early stage tumor detection (OR=2.08; 95% CI, 1.8-2.37) and curative treatment rates (OR=2.24; 95% CI 1.99-2.52).

The HCC surveillance group also displayed significantly prolonged survival rates (OR=1.9; 95% CI, 1.67-2.17), with pooled 3-year survival rates of 50.8% among surveillance patients, compared with 27.9% among patients without previous surveillance (P<.001). Prolonged survival rates from patients who underwent HCC surveillance vs. those who did not (39.7% vs. 29.1%) were significant among six studies that accounted for lead-time bias. Researchers defined bias as time from when disease normally would be diagnosed without screening vs. when the disease is detected with screening.

“The preponderance of data that consistently demonstrate benefits should provide sufficient rationale to recommend HCC surveillance, even in the absence of a randomized controlled trial among patients with cirrhosis,” the investigators concluded.

Disclosure:The researchers report no relevant financial disclosures.