ArticlePLoS neglected tropical diseases2016
Watch and Wait Management of Inactive Cystic Echinococcosis - Does the Path to Inactivity Matter - Analysis of a Prospective Patient Cohort.
Article in PLoS neglected tropical diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses 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.
The trial behind it
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.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 65 citations in OpenAlex.
- Treatment of uncomplicated hepatic cystic echinococcosis (hydatid disease).The Cochrane database of systematic reviews · 2024Pooled it
- Percutaneous Versus Surgical Interventions for Hepatic Cystic Echinococcosis: A Systematic Review and Meta-Analysis.Cardiovascular and interventional radiology · 2021Pooled it
- Endocystectomy as a conservative surgical treatment for hepatic cystic echinococcosis: A systematic review with single-arm meta-analysis.PLoS neglected tropical diseases · 2021Pooled it
- Role of interventional radiology in the management of hepatic hydatid disease.World journal of radiology · 2026Review
- The Role of Innate Lymphoid Cells in the Pathogenesis of Hepatic Echinococcosis: A Literature Review.Parasite immunology · 2026Review
- Computed Tomography (CT) Patterns of Hepatic Cystic Echinococcosis (CE) Cysts: A 19-Year Retrospective Study at a Tertiary Center in Sana'a, Yemen.Journal of epidemiology and global health · 2025Article
- The Diagnostic Challenge of Cystic Echinococcosis in Humans: First Assessment of Underreporting Rates in Mongolia.Tropical medicine and infectious disease · 2024Article
- Turkish HPB Surgery Association consensus report on hepatic cysticTurkish journal of surgery · 2022Article
- Proteomic analysis of plasma exosomes from Cystic Echinococcosis patients provides in vivo support for distinct immune response profiles in active vs inactive infection and suggests potential biomarkers.PLoS neglected tropical diseases · 2020Article
- The European Register of Cystic Echinococcosis, ERCE: state-of-the-art five years after its launch.Parasites & vectors · 2020Article
- Comment on: "Complications Associated with Initial Clinical Presentation of Cystic Echinococcosis: A 20-year Cohort Analysis".The American journal of tropical medicine and hygiene · 2020Article
- Standardized endocystectomy technique for surgical treatment of uncomplicated hepatic cystic echinococcosis.PLoS neglected tropical diseases · 2019Article
- Severe chest allodynia as an unusual first presentation of hydatid disease: a case report.BMC infectious diseases · 2019Article
- Case Report: Percutaneous Treatment of Multiple Echinococcal Cysts Presenting as Abdominal Palpable Mass.The American journal of tropical medicine and hygiene · 2019Article
- Evaluation of the recombinant antigens B2t and 2B2t, compared with hydatid fluid, in IgG-ELISA and immunostrips for the diagnosis and follow up of CE patients.PLoS neglected tropical diseases · 2018Article
- Watch and Wait Approach for Inactive Echinococcal Cyst of the Liver: An Update.The American journal of tropical medicine and hygiene · 2018Article
- Patients with cystic echinococcosis in the three national referral centers of Mongolia: A model for CE management assessment.PLoS neglected tropical diseases · 2018Article
- Structural and Immunodiagnostic Characterization of Synthetic Antigen B Subunits From Echinococcus granulosus and Their Evaluation as Target Antigens for Cyst Viability Assessment.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Article
- Proton Nuclear Magnetic Resonance (Euroasian journal of hepato-gastroenterologyArticle
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOverdiagnosis and overtreatment are rarely discussed in the context of NTDs despite their relevance for patients under the care of health services with limited resources where the risks of therapy induced complications are often disproportionate to the benefit. The advantages of cyst staging-based management of patients with cystic echinococcosis (CE) are not yet fully explored. Questions are: Do inactive cysts (CE 4 and CE 5) need treatment and is there a difference between cysts which reach CE4 and CE5 naturally or by benzimidazole therapy? METHODOLOGY/PRINCIPAL
findingsAnalysis of long-term follow-up data from a prospective CE patient cohort of 223 patients of a national clinical center for echinococcosis. The event of interest "relapse" was defined as the reversal of a cyst from an inactive stage (CE4, CE5) back to an active stage. The watch &wait (ww) group included 30 patients with 46 inactive cysts who never received medical treatment. The benzimidazole-treated (med) group included 15 patients with 17 cysts. There was no relapse in the ww-group whereas 8/17 cysts showed relapse within 18 months after treatment in the med-group. Loss to follow-up was 15.5%.
conclusionsData from the watch & wait group impressively show how stable naturally inactivated cysts are in contrast to cysts which reach inactivity through treatment with benzimidazoles. A substantial proportion of patients can be spared from treatment through cyst staging. Cysts which inactivated through a natural course do not relapse with very high likelihood. We recommend follow up of 5 years to confirm the stability of the inactive stage. Cysts driven into inactivity through benzimidazole therapy instead need careful monitoring to identify those which reactivate (around 50% within 18 months). 5 years follow-up appears safe to make a final decision on the need for further monitoring.
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Registered trials
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