ArticleBMC cancer2025
Optimal surveillance intervals for hepatocellular carcinoma screening in cirrhotic patients with hepatitis C infection: a Taiwanese national cohort study.
Article in BMC cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHepatocellular carcinoma (HCC) surveillance guidelines recommend ultrasound screening every 6 months, which was determined empirically. Since liver disease progression is heterogeneous among different etiologies, it is clinically valuable to analyze patients with specific etiologies. The aim of this study was to evaluate the impact of surveillance intervals, duration of cirrhosis, and HCC risk factors on the survival of hepatitis C virus (HCV) cirrhotic patients.
methodsThis nationwide cohort study included adult patients who were newly diagnosed as having HCV-related cirrhosis between January 2007 and December 2018. 5,093 newly diagnosed cirrhotic HCV related HCC patients were analyzed. The timing of ultrasonography screening was categorized into 4 cohorts: 0- to 6-month cohort (6-month cohort), 7- to 12-month cohort (12-month cohort), 13- to 24-month cohort (24-month cohort), and not screened within 2 years cohort (unscreened cohort). The chance of early stage of HCC diagnosis and receiving curative treatment were calculated. Association between surveillance interval and all-cause mortality was analyzed adjusting for lead-time bias.
resultsThe 6-month group had the highest likelihood of being diagnosed with an early-stage HCC, followed by the 12-month group (OR = 0.69; 95% CI 0.55-0.85) and the 24-month group (OR = 0.355; 95% CI 0.27-0.47), the last by the unscreened group (OR = 0.296; 95% CI 0.22-0.40). The 6-month group had the highest likelihood of being received curative treatment, followed by the 12-month group (OR = 0.721, 95% CI 0.58-0.89) and the 24-month group (OR = 0.584; 95% CI 0.44-0.77), the last by the unscreened group (OR = 0.513; 95% CI 0.38-0.69). The 6-month group had the least likelihood of all-cause mortality, followed by the 12-month group (HR = 1.134; 95% CI 1.02-1.26), the 24-month group (HR = 1.570; 95% CI 1.39-1.77), and the unscreened group (HR = 1.520; 95% CI 1.33-1.73). After adjusting for lead-time bias, the 6-month group had the least likelihood of all-cause mortality. In the 6-month group, cirrhotic HCV patients with an AFP less than 20 ng/ml, with a MELD score less than 20, with cirrhosis duration between 3-5 years had better survival.
conclusionA 6-month surveillance interval can significantly improve the detection rate of early-stage HCC, likelihood of receiving curative treatment, and prolong the overall survival of cirrhotic HCV patients.
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