Clinical outcomes of hepatocellular carcinoma surveillance in Melbourne, Australia

• DOI: 10.1111/imj.16405
• Publication Date: 2024-04-26T11:19:02Z
• Authors: Samuel Hui; Andrew Nguyen; Suong Le; Anouk Dev; Sally Bell
• Keywords: Male; Adult; 0303 health sciences; Carcinoma, Hepatocellular; Victoria; Liver Neoplasms; Australia; Middle Aged; 03 medical and health sciences; Population Surveillance; Humans; Female; Early Detection of Cancer; Aged; Ultrasonography; Retrospective Studies

Abstract Background Ultrasound surveillance for hepatocellular carcinoma (HCC) may improve early tumour detection but additionally result in surveillance‐related harm through increased evaluation of non‐HCC lesions. The incidence these outcomes has not been reported outside North America. Aims We aimed to report the HCC with respect both benefits and harms. Methods reviewed all ultrasounds at a large Victorian tertiary hospital network 2017 followed their until 2021. Surveillance‐related were defined as early‐stage detection. was contrast imaging, biopsies or surgery performed evaluate liver lesions false‐positive alpha‐fetoprotein levels. Results Five hundred fifty‐three patients included (mean age 54.5 ± 12.3 years, males 67.5%, cirrhosis 50.3%). most common disease aetiology hepatitis B (53.9%). Over median 4.7 years follow‐up, detected 3.3% (5.4% cirrhotic vs 1.1% non‐cirrhotic patients, P < 0.01). 75% HCCs early‐stage. occurred 12.5% (15.5% 9.5% 0.04), although mild (12.1%). In subgroup analysis, ranged between 0% (screened guideline criteria alcoholic patients) 7.2% (hepatitis C cirrhosis). Harm 9% (non‐cirrhotic B) 20.8% (thrombocytopenia). Conclusion our study, associated detection, many experienced harm. Novel strategies pathways are required high‐risk minimise low‐risk patients.