Influence of hepatocarcinoma surveillance programs on cirrhotic patient’s survival: a real life study.

Resumen

Background: Hepatocellular carcinoma (HCC) represents 75%-85% of all primary liver cancers and the third most common cause of cancer-related death worldwide. Cirrhosis is the most relevant risk factor for HCC with 70%-90% of cases diagnosed at end-stage liver disease. Several studies have revealed that early diagnosis of HCC under surveillance improves both prognosis and availability of major curative options.

Aim: to determine current HCC surveillance impact on survival at a university hospital.

Methods: we retrospectively gathered all HCC diagnosed between Jan 2012 and May 2018 at a university hospital in Málaga(Spain). Inclusion criteria were all space-occupying lesions (SOL) diagnosed at our centre and exclusion criteria were all non-HCC SOL and HCC diagnosed before or after the given dates. Epidemiological, etiological, liver-function, clinical, tumor-related, therapeutic and response-to-treatment variables were collected.

Results: 159 patients were finally included. 92.5% of HCC were diagnosed on cirrhotic patients. Following the Barcelona Clinic Liver Cancer (BCLC) staging classification, 73% of patients who underwent surveillance were diagnosed on 0, A or B stages, whereas 38% of patients who didn’t perform surveillance were diagnosed on given stages. The surveillance-applying cluster had a 33 months survival median while the not-surveillance cohort showed a survival of 6 months. The median survival on early stages (0 and A) [50 months], stage B (20 months), stage C (10 months) and stage D (2 months) showed statistically significant differences.

Conclusions: HCC surveillance programs allow early diagnosis on favorable tumor stages, increasing chances of major treatment options, and life expectancy of patients.

Keywords: hepatocellular carcinoma, surveillance, cirrhosis, survival.