[Surveillance for hepatocellular carcinoma: does it work?]

Tunis Med. 2007 Oct;85(10):866-70.
[Article in French]

Abstract

Background: The surveillance of cirrhotic patients for early detection of hepatocellular carcinoma is recommended but its efficacy is now discussed. The aim of our study was to present the results of a screening program in 110 patients.

Methods: it is a retrospective study that included 110 patients with cirrhosis in a screening program of hepatocellular carcinoma, based on the realization of abdominal ultrasound exam and the determination of alpha-fetoprotein amount every 6 months in 95 patients and every 3 months in 15 patients.

Results: the mean duration of the surveillance was 36 months. A hepatocellular carcinoma was diagnosed in 13 patients. Curative treatment was done in only 3 cases and consisted in a hepatic resection in 1 patient and an alcoolisation in 2 cases. Ten patients had new treatment : for 8 patients the discussed was very agressive and 2 patients had a server hepotic failure. The cost of this study was 37.500 Tunisian dinars.

Conclusions: systematic screening for hepatocellular carcinoma offer a limited cost effectiveness ratio.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / diagnosis*
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Early Diagnosis
  • Embolization, Therapeutic
  • Female
  • Hepatectomy
  • Humans
  • Liver Cirrhosis / complications*
  • Liver Cirrhosis / diagnostic imaging
  • Liver Failure / etiology
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / diagnostic imaging
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Population Surveillance
  • Prospective Studies
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • Ultrasonography
  • alpha-Fetoproteins / analysis

Substances

  • alpha-Fetoproteins