ArticleHepatology (Baltimore, Md.)2020
Hepatocellular Carcinoma Demonstrates Heterogeneous Growth Patterns in a Multicenter Cohort of Patients With Cirrhosis.
Article in Hepatology (Baltimore, Md.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers, 9 of them syntheses that pooled it.
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Who cites it
91 citing papers in PubMed, 9 syntheses or guidelines pooled it, 131 citations in OpenAlex.
- Racial and Ethnic Disparities in Survival among Patients with Cholangiocarcinoma in the United States: A Systematic Review and Meta-analysis.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025Pooled it
- Racial and Ethnic Disparities in Hepatocellular Carcinoma Treatment Receipt in the United States: A Systematic Review and Meta-Analysis.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2024Pooled it
- Effect of coronavirus disease 2019 on diagnosis and treatment of hepatocellular carcinoma: a systematic review.Exploration of targeted anti-tumor therapy · 2023Pooled it
- HCC surveillance improves early detection, curative treatment receipt, and survival in patients with cirrhosis: A meta-analysis.Journal of hepatology · 2022Pooled it
- Racial and Ethnic Disparities in Survival Among Patients With Hepatocellular Carcinoma in the United States: A Systematic Review and Meta-Analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2022Pooled it
- Systematic review: radiomics for the diagnosis and prognosis of hepatocellular carcinoma.Alimentary pharmacology & therapeutics · 2021Pooled it
- Hepatocellular carcinoma tumour volume doubling time: a systematic review and meta-analysis.Gut · 2021Pooled it
- WGO Guidance for the Care of Patients With COVID-19 and Liver Disease.Journal of clinical gastroenterology · 2021Guideline
- Management of liver diseases during the pandemic of coronavirus disease-19.Clinical and molecular hepatology · 2020Guideline
- Development and validation of risk stratification models for hepatocellular cancer: A framework from the translational liver cancer consortium.Hepatology (Baltimore, Md.) · 2026Review
- Cost-effectiveness of HES V2.0 and GALAD for hepatocellular carcinoma surveillance in patients with cirrhosis.Hepatology communications · 2026Article
- Causes of mortality among patients with early-stage hepatocellular carcinoma.Hepatology (Baltimore, Md.) · 2026Article
- Management and Prognosis of HCC Patients With Elevated Tumor Markers but no Imaging Recurrence After Radiofrequency Ablation.Cancer medicine · 2026Article
- Very Early-Stage Detection Is Associated With Improved Survival in Patients With Unifocal Hepatocellular Carcinoma.Alimentary pharmacology & therapeutics · 2026Article
- [Chinese expert consensus on the use of standardized second-line drugs for primary hepatocellular carcinoma].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Article
- Article
- Impact of Microwave Ablation on Growth Kinetics of Residual versus Synchronous Untreated Hepatocellular Carcinoma: A Retrospective Cohort Study.Journal of hepatocellular carcinoma · 2026Article
- Article
- Hepatocellular Carcinoma Growth Kinetics and Outcomes After Transarterial Embolization: A Single-Center Analysis.Cancers · 2025Article
- Impact of age on clinical outcomes among patients with hepatocellular carcinoma: A systematic review and meta-analysis.JHEP reports : innovation in hepatology · 2025Article
31 more citing papers are in PubMed but not listed here.
Corrections and comments
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- Commented on byREPLY.2021
Authors and funding
21 authors at 7 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimsThere are limited data on hepatocellular carcinoma (HCC) growth patterns, particularly in Western cohorts, despite implications for surveillance, prognosis, and treatment. Our study's aim was to quantify tumor doubling time (TDT) and identify correlates associated with indolent and rapid growth. APPROACH AND
resultsWe performed a retrospective multicenter cohort study of patients with cirrhosis diagnosed with HCC from 2008 to 2017 at six US and European health systems with two or more contrast-enhanced imaging studies performed ≥ 30 days apart prior to HCC treatment. Radiologists independently measured tumors in three dimensions to calculate TDT and specific growth rate (SGR). We used multivariable ordinal logistic regression to identify factors associated with indolent (TDT > 365 days) and rapid (TDT < 90 days) tumor growth. In the primary cohort (n = 242 patients from four centers), median TDT was 229 days (interquartile range [IQR], 89-627) and median SGR was 0.3% per day (IQR, 0.1%-0.8%). Over one-third (38%) of HCCs had indolent growth, 36.8% intermediate growth, and 25.2% rapid growth. In multivariable analysis, indolent growth was associated with larger tumor diameter (odds ratio [OR], 1.15, 95% confidence interval [CI], 1.03-1.30) and alpha-fetoprotein < 20 ng/mL (OR, 1.90; 95% CI, 1.12-3.21). Indolent growth was more common in nonviral than viral cirrhosis (50.9% versus 32.1%), particularly in patients with T1 HCC (OR, 3.41; 95% CI, 1.08-10.80). Median TDT (169 days; IQR 74-408 days) and SGR (0.4% per day) were similar in an independent cohort (n = 176 patients from two centers).
conclusionsIn a large Western cohort of patients with HCC, we found heterogeneous tumor growth patterns, with one-fourth exhibiting rapid growth and over one-third having indolent growth. Better understanding different tumor growth patterns may facilitate a precision approach to prognostication and treatment.
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