Surveillance for hepatocellular carcinoma in patients with primary biliary cirrhosis.
Journal Article (Journal Article)
UNLABELLED: Hepatocellular carcinoma (HCC) occurs with increased frequency in patients with primary biliary cirrhosis (PBC). Effectiveness of surveillance recommendations for HCC is controversial, and data are lacking in patients with PBC. In this study, we attempt to (1) establish the importance of surveillance for HCC in patients with PBC; (2) identify a target population of patients with PBC for HCC surveillance; and (3) propose surveillance recommendations for patients with PBC. We retrospectively identified 36 patients seen at the Mayo Clinic between 1976 and 2007 with a diagnosis of both PBC and HCC. Five patients (14%) were diagnosed incidentally, 17 patients comprised our surveillant population, and 14 patients were diagnosed outside a surveillance program. Patients in the surveillant population were more likely to undergo therapy (88% versus 43%; P = 0.01) and had improved survival (P = 0.002) compared with the nonsurveillant population. All cases of HCC except one were predicted to be at significant risk for HCC based on age, sex, evidence of portal hypertension, and history of blood transfusion using a previous predictive model. CONCLUSION: We established the importance of surveillance for HCC in patients with PBC. We demonstrated adequate performance of a predictive model and propose it should be refined and used to identify patients with PBC who should be screened for development of HCC. Further studies are needed so that optimal HCC surveillance recommendations in this population can be determined and included in the practice guidelines for PBC.
Full Text
Duke Authors
Cited Authors
- Silveira, MG; Suzuki, A; Lindor, KD
Published Date
- October 2008
Published In
Volume / Issue
- 48 / 4
Start / End Page
- 1149 - 1156
PubMed ID
- 18785621
Electronic International Standard Serial Number (EISSN)
- 1527-3350
Digital Object Identifier (DOI)
- 10.1002/hep.22458
Language
- eng
Conference Location
- United States