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Bi-annual liver cancer screening for cirrhosis improves diagnosis, survival

Compliance with hepatocellular carcinoma surveillance correlated with early diagnosis, better allocation of curative treatment and longer overall survival among patients with hepatitis C- or hepatitis B-associated compensated cirrhosis, according to a recently published study.

“Monitoring for HCC in patients with cirrhosis, based on bi-annual ultrasound examination is recommended by international guidelines,” Charlotte Costentin, MD, from the Hôpital Henri Mondor in France, and colleagues wrote. “Improving compliance with surveillance guidelines should translate into a significant improvement in the prognosis of this deadly cancer.”

During a median follow-up of 59.7 months (range, 37.2-80.7 months), 225 of 1,761 patients developed primary liver cancer. Specifically, 216 developed HCC and nine developed intrahepatic cholangiocarcinoma. Approximately 60% of patients who developed liver cancer complied with HCC surveillance guidelines.

The median period between diagnostic imaging and previous imaging was 5.8 months (range, 5.1-6.3 months) in the complaint group and 10.5 months (range, 8.2-14) among those who did not comply with surveillance guidelines.

The median overall survival rate was significantly shorter among noncompliant patients compared with complaint patients (30 vs. 57.8 months; P = .0121), which remained significant after lead-time adjustment (25.4 vs. 53.2 months; P = .0107).

Multivariate analysis showed that surveillance timeframe remained significantly correlated with higher rates of tumor diagnosis at Barcelona Clinic Liver Cancer stage 0 or A, better curative treatment allocation rates, and increased survival (HR = 2.19; 95% CI, 1.16-4.14).

“During our study, the difference in survival observed between patients compliant and not compliant with the surveillance guidelines was striking, as the median timeframe only exceeded the recommended periodicity in the noncompliant group by 4 months,” the researchers wrote. “Importantly, there were no differences between the two patient groups in terms of their characteristics at baseline or at the time of last normal imaging, and particularly age, drinking behavior and ethnicity.” – by Talitha Bennett

Disclosure: Costentin reports no relevant financial disclosures. Please see the full study for the other authors’ relevant financial disclosures.