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Studies of patients with cirrhosis uncover limitations in liver cancer screening
Date:12/1/2011

" explains Professor George. "Since HCC screening in cirrhotic patients is routine practice for a majority of clinicians, it is impossible to assign patients to a genuine control group. However, further prospective studies that compare individual screening strategies are warranted." In a survey of 40 gastroenterologists of the Sydney Liver Group, the authors found that 74% routinely screen cirrhotic patients despite believing that screening did not increase patient survival (37%) or that the surveillance was cost-effective (66%).

One such liver cancer screening strategy was investigated by a team of French and Belgian researchers led by Professor Jean-Claude Trinchet with the Hpital Jean Verdier in Bondy, France. The team conducted a multicentre trial with 1278 cirrhotic patients who received ultrasonographic screening at either three-month or six-month intervals. Their results indicated that cirrhosis resulted from excessive alcohol use in 39% of participants, 44% from hepatitis C virus (HCV), and 13% from hepatitis B virus (HBV). During the study period from July 2000 to July 2009, researchers detected at least one focal lesion in 28% of patients, but confirmed small HCC (less than 30 mm) in only 10% of participants.

Dr. Trinchet said, "Our study found that ultrasonographic surveillance performed every three months detects more small focal lesions than screening at six-month intervals. However, more frequent screening did not improve the detection of liver cancer at an earlier stage." The authors note that detection of small tumors were more likely missed in patients with HCV or who abuse alcohol and suggest the limitations of current diagnostic procedures may explain their negative findings. Again, further investigations of screening methods and diagnostic procedures are needed to improve the outcomes in those at risk for developing liver cancer.


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Contact: Dawn Peters
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Wiley-Blackwell
Source:Eurekalert

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