ArticleAlimentary pharmacology & therapeutics2016
Cirrhosis is under-recognised in patients subsequently diagnosed with hepatocellular cancer.
Article in Alimentary pharmacology & therapeutics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Obesity facts · 2024Guideline
- Missed Diagnosis in Alcohol-Related Hepatocellular Carcinoma: A Call for Alcohol Consumption and Liver Disease Early Detection.Liver international : official journal of the International Association for the Study of the Liver · 2026Review
- Differential Impact of Metabolic Bariatric Surgery Versus Semaglutide on Adverse Hepatic and Extrahepatic Outcomes in Individuals With Metabolic Dysfunction-Associated Steatotic Liver Disease and Type 2 Diabetes.Diabetes, obesity & metabolism · 2026Article
- Arthritis and High Alcohol Intake at Diagnosis Increase Future Risk of Hepatocellular Carcinoma inGastro hep advances · 2026Article
- Identifying determinants of viral hepatitis and liver cancer care in Michigan Asian American communities through multilevel engagement.Hepatology communications · 2025Article
- The Real-World Prevalence of Esophagogastric Varices, Bleeding, Emergency Room Visits, and Hospitalization Among Patients with Advanced Hepatocellular Carcinoma in the United States: A Retrospective Cohort Study.Journal of hepatocellular carcinoma · 2025Article
- Three-year of hepatocellular carcinoma surveillance in patients with cirrhosis diagnosed between 2009 and 2013: a cohort study based on the French National Health Data System (SNDS) claims data.Frontiers in oncology · 2025Article
- Undiagnosed Cirrhosis and Hepatic Encephalopathy in a National Cohort of Veterans With Dementia.JAMA network open · 2024Article
- Single-cell sequencing and multiple machine learning algorithms to identify key T-cell differentiation gene for progression of NAFLD cirrhosis to hepatocellular carcinoma.Frontiers in molecular biosciences · 2024Article
- Hepatocellular carcinoma surveillance - utilization, barriers and the impact of changing aetiology.Nature reviews. Gastroenterology & hepatology · 2023Review
- Application and progress of the detection technologies in hepatocellular carcinoma.Genes & diseases · 2023Review
- Prevention of Hepatocellular Carcinoma (HCC). White Paper of the Texas Collaborative Center for Hepatocellular Cancer (TeCH) Multi-stakeholder Conference.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Prediagnostic CT or MRI Utilization and Outcomes in Hepatocellular Carcinoma: SEER-Medicare Database Analysis.Cancer research communications · 2023Article
- Biological Role of Zinc in Liver Cirrhosis: An Updated Review.Biomedicines · 2023Review
- Factors associated with unrecognized cirrhosis in patients with hepatocellular carcinoma.Clinical and molecular hepatology · 2023Article
- Clinical Characteristics and Outcomes of Nonalcoholic Fatty Liver Disease-Associated Hepatocellular Carcinoma in the United States.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Unrecognized liver cirrhosis is common and associated with worse survival in hepatocellular carcinoma: A nationwide cohort study of 3473 patients.Journal of internal medicine · 2023Article
- Targeting population groups with heavier burden of hepatocellular carcinoma incidence: A nationwide descriptive epidemiological study in Sweden.International journal of cancer · 2022Article
- Barriers to Surveillance for Hepatocellular Carcinoma in a Multicenter Cohort.JAMA network open · 2022Article
- Alcohol-related hepatocellular carcinoma is a heterogenous condition: Lessons from a latent class analysis.Liver international : official journal of the International Association for the Study of the Liver · 2022Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundMost clinical practice guidelines recommend screening for HCC in patients with cirrhosis. However, patients with compensated cirrhosis are often asymptomatic and may remain unrecognised for years.
aimsTo determine the extent to which cirrhosis is unrecognised in a US Veteran population with HCC, and to evaluate the association between lack of cirrhosis recognition and stage of HCC at diagnosis.
methodsWe reviewed the electronic medical records of a random sample of HCC cases diagnosed in the national Veterans Affairs system between 2005 and 2011. We conducted multivariable analyses adjusting for patients' demographics, comorbidity, aetiology of underlying disease and healthcare utilisation including HCC surveillance.
resultsOf 1201 patients with HCC and cirrhosis, 24.6% had unrecognised cirrhosis prior to HCC diagnosis. Older patients [>65 years, odds ratio (OR) 2.32], African Americans (OR 1.93), patients with alcoholic or NAFLD liver disease (OR 1.69 and 4.77 respectively), HIV (OR 3.02), and fewer comorbidities (Deyo 0 vs. 3, OR 2.42) had significantly higher odds of having unrecognised cirrhosis than comparison groups. Furthermore, patients with unrecognised cirrhosis were 6.5 times more likely to have advanced stage HCC at diagnosis. The effect of cirrhosis recognition on HCC stage remained significant after adjusting for pre-specified covariates (OR 3.37).
conclusionsIn one quarter of patients, cirrhosis was unrecognised prior to HCC diagnosis, and this group was significantly more likely to have advanced stage HCC. These findings emphasise the importance of timely evaluation for cirrhosis in at-risk populations as a critical step to improving outcomes for patients with HCC.
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