Screening for hepatocarcinoma in a cohort with cirrhosis mainly of alcoholic origin

To assess the feasibility and efficiency of the screening for hepatocarcinoma in a cohort of cirrhoseis mainly of alcoholic origin. 293 patients with cirrhosis, among them 186 (63.5%) from alcoholic origin, were included in a surveillance programme for hepatocarcinoma by carrying out liver ultrasono...

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Veröffentlicht in:Gastroentérologie clinique et biologique 2003-05, Vol.27 (5), p.534
Hauptverfasser: Henrion, Jean, Libon, Ernest, De Maeght, Stéphane, Deltenre, Pierre, Schapira, Michaël, Ghilain, Jean-Michel, Maisin, Jean-Marc, Heller, Francis R
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container_title Gastroentérologie clinique et biologique
container_volume 27
creator Henrion, Jean
Libon, Ernest
De Maeght, Stéphane
Deltenre, Pierre
Schapira, Michaël
Ghilain, Jean-Michel
Maisin, Jean-Marc
Heller, Francis R
description To assess the feasibility and efficiency of the screening for hepatocarcinoma in a cohort of cirrhoseis mainly of alcoholic origin. 293 patients with cirrhosis, among them 186 (63.5%) from alcoholic origin, were included in a surveillance programme for hepatocarcinoma by carrying out liver ultrasonography and alpha-foetoprotein dosage every 6 months. Results were analyzed with a mean follow-up of 60 months. Seventeen hepatocarcinoma discovered through the surveillance programme ("screened HCC") were compared with 40 hepatocarcinoma discovered outside the surveillance programme during the same period ("incidental HCC"). The alcoholic origin of the cirrhosis was a predictive factor of poor compliance to the surveillance programme. Among the 186 patients with alcoholic cirrhosis, 129 (69%) were lost during the surveillance programme due to lack of compliance (97 cases) or death (32 cases). By comparison, among the 65 patients with hepatitis C-related cirrhosis, 18 were lost by lack of compliance (11 cases) or death (7 cases) (P
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Results were analyzed with a mean follow-up of 60 months. Seventeen hepatocarcinoma discovered through the surveillance programme ("screened HCC") were compared with 40 hepatocarcinoma discovered outside the surveillance programme during the same period ("incidental HCC"). The alcoholic origin of the cirrhosis was a predictive factor of poor compliance to the surveillance programme. Among the 186 patients with alcoholic cirrhosis, 129 (69%) were lost during the surveillance programme due to lack of compliance (97 cases) or death (32 cases). By comparison, among the 65 patients with hepatitis C-related cirrhosis, 18 were lost by lack of compliance (11 cases) or death (7 cases) (P&lt;0.001). Moreover, sustained or relapsing alcohol abuse after inclusion in the surveillance programme were also related to the quality of the compliance. Seventeen hepatocarcinoma were discovered through the surveillance giving an annual incidence of 2% for the emergence of hepatocarcinoma. The comparison between screened (n=17) and incidental (n=40) hepatocarcinoma showed that screened HCC were more often asymptomatic (P&lt;0.01), were more often a solitary nodule less than 5 cms (P&lt;0.001) and underwent more often curative treatment (P=0.02). However, the survival between screened and incidental hepatocarcinoma was not different. Screening for hepatocarcinoma in patients with alcoholic cirrhosis is a difficult task due to poor compliance and early death. 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The comparison between screened (n=17) and incidental (n=40) hepatocarcinoma showed that screened HCC were more often asymptomatic (P&lt;0.01), were more often a solitary nodule less than 5 cms (P&lt;0.001) and underwent more often curative treatment (P=0.02). However, the survival between screened and incidental hepatocarcinoma was not different. Screening for hepatocarcinoma in patients with alcoholic cirrhosis is a difficult task due to poor compliance and early death. According to our results, a surveillance every 6 months is sufficient to detect early lesions accessible to curative treatment by surgical resection or transcutaneous ablation.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>alpha-Fetoproteins - metabolism</subject><subject>Biopsy</subject><subject>Carcinoma, Hepatocellular - blood</subject><subject>Carcinoma, Hepatocellular - diagnosis</subject><subject>Carcinoma, Hepatocellular - etiology</subject><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Cohort Studies</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Hepatitis C - complications</subject><subject>Humans</subject><subject>Liver Cirrhosis - complications</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>Liver Cirrhosis - virology</subject><subject>Liver Cirrhosis, Alcoholic - complications</subject><subject>Liver Cirrhosis, Alcoholic - diagnosis</subject><subject>Liver Neoplasms - blood</subject><subject>Liver Neoplasms - diagnosis</subject><subject>Liver Neoplasms - etiology</subject><subject>Liver Neoplasms - mortality</subject><subject>Male</subject><subject>Mass Screening - methods</subject><subject>Mass Screening - psychology</subject><subject>Mass Screening - standards</subject><subject>Middle Aged</subject><subject>Patient Compliance - psychology</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Survival Analysis</subject><subject>Ultrasonography - methods</subject><subject>Ultrasonography - standards</subject><issn>0399-8320</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1j8tKw0AUhmeh2Fp9BTkvEJhLMpelFG9Q6KLdl8nJTHMkmQmTiPTtVdTVv_n4-P4rtubKucoqyVfsdp7fOefWGXHDVkLaWjlh1-xwwBJConSGmAv0YfJLRl-QUh49UAIPmPtcFvikpQekUvo80wyjpzRcIEfwww8xEEIudKZ0x66jH-Zw_7cbdnx-Om5fq93-5W37uKsmodxSYVdHNNa2Ta0xxha1jbZpdCM4N67TKsQgO9VKHRvpv9OdMNxFaTzXBlFt2MOvdvpox9CdpkKjL5fT_zn1BcsYS2Q</recordid><startdate>200305</startdate><enddate>200305</enddate><creator>Henrion, Jean</creator><creator>Libon, Ernest</creator><creator>De Maeght, Stéphane</creator><creator>Deltenre, Pierre</creator><creator>Schapira, Michaël</creator><creator>Ghilain, Jean-Michel</creator><creator>Maisin, Jean-Marc</creator><creator>Heller, Francis R</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope></search><sort><creationdate>200305</creationdate><title>Screening for hepatocarcinoma in a cohort with cirrhosis mainly of alcoholic origin</title><author>Henrion, Jean ; 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Results were analyzed with a mean follow-up of 60 months. Seventeen hepatocarcinoma discovered through the surveillance programme ("screened HCC") were compared with 40 hepatocarcinoma discovered outside the surveillance programme during the same period ("incidental HCC"). The alcoholic origin of the cirrhosis was a predictive factor of poor compliance to the surveillance programme. Among the 186 patients with alcoholic cirrhosis, 129 (69%) were lost during the surveillance programme due to lack of compliance (97 cases) or death (32 cases). By comparison, among the 65 patients with hepatitis C-related cirrhosis, 18 were lost by lack of compliance (11 cases) or death (7 cases) (P&lt;0.001). Moreover, sustained or relapsing alcohol abuse after inclusion in the surveillance programme were also related to the quality of the compliance. Seventeen hepatocarcinoma were discovered through the surveillance giving an annual incidence of 2% for the emergence of hepatocarcinoma. The comparison between screened (n=17) and incidental (n=40) hepatocarcinoma showed that screened HCC were more often asymptomatic (P&lt;0.01), were more often a solitary nodule less than 5 cms (P&lt;0.001) and underwent more often curative treatment (P=0.02). However, the survival between screened and incidental hepatocarcinoma was not different. Screening for hepatocarcinoma in patients with alcoholic cirrhosis is a difficult task due to poor compliance and early death. According to our results, a surveillance every 6 months is sufficient to detect early lesions accessible to curative treatment by surgical resection or transcutaneous ablation.</abstract><cop>France</cop><pmid>12843918</pmid></addata></record>
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subjects Aged
Aged, 80 and over
alpha-Fetoproteins - metabolism
Biopsy
Carcinoma, Hepatocellular - blood
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - etiology
Carcinoma, Hepatocellular - mortality
Cohort Studies
Feasibility Studies
Female
Hepatitis C - complications
Humans
Liver Cirrhosis - complications
Liver Cirrhosis - diagnosis
Liver Cirrhosis - virology
Liver Cirrhosis, Alcoholic - complications
Liver Cirrhosis, Alcoholic - diagnosis
Liver Neoplasms - blood
Liver Neoplasms - diagnosis
Liver Neoplasms - etiology
Liver Neoplasms - mortality
Male
Mass Screening - methods
Mass Screening - psychology
Mass Screening - standards
Middle Aged
Patient Compliance - psychology
Prognosis
Risk Factors
Survival Analysis
Ultrasonography - methods
Ultrasonography - standards
title Screening for hepatocarcinoma in a cohort with cirrhosis mainly of alcoholic origin
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