Effect of hepatocellular carcinoma surveillance programmes on overall survival in a mixed cirrhotic UK population: a prospective, longitudinal cohort study

Haq, M. I. et al. (2021) Effect of hepatocellular carcinoma surveillance programmes on overall survival in a mixed cirrhotic UK population: a prospective, longitudinal cohort study. Journal of Clinical Medicine, 10(13), 2770. (doi: 10.3390/jcm10132770) (PMID:34202593) (PMCID:PMC8269358)

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Abstract

Introduction: Surveillance for hepatocellular carcinoma (HCC) is recommended by national and international guidelines. However, there are no trial data on whether surveillance improves clinical outcomes in a UK cirrhosis population of mixed aetiology. Our aim was to determine the impact of, and adherence to, surveillance on overall survival. Methods: We prospectively collected data on consecutive patients diagnosed with HCC between January 2009 and December 2015 at two large UK centres. We assessed outcomes depending on whether they had been entered into an HCC surveillance programme, and if they had adhered to that. Results: Out of 985 patients diagnosed with HCC in this study, 40.0% had been enrolled in a surveillance programme. Of these, 76.6% were adherent with surveillance and 24.4% were not. Adherence to surveillance was significantly associated with improved overall survival, even when accounting for lead-time bias using different approaches (HR for 270 days lead-time adjustment 0.64, 0.53 to 0.76, p 0.001). Conclusions: When adjusted for lead-time bias, HCC surveillance is associated with improved overall survival; however, the beneficial effect of surveillance on survival was lower than reported in studies that did not account fully for lead-time bias.

Item Type:Articles
Additional Information:Thomas G Bird was supported by a Wellcome Trust Intermediate Fellowship (WT/107492Z) for the course of this work.
Keywords:HCC, hepatocellular carcinoma, cirrhosis, surveillance, cancer screening, lead-time.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Ahmed Hassan Elshiekh, Mrs Asma and Stanley, Dr Adrian and Evans, Professor Jeff and Drake, Dr Thomas and Forrest, Dr Ewan and Ballantyne, Dr Stuart and Bird, Dr Thomas and Graham, Dr Janet and McMillan, Professor Donald and Gillespie, Dr Ruth
Authors: Haq, M. I., Drake, T. M., Goh, T. L., Ahmed, A., Forrest, E., Barclay, S., Gillespie, R., Priest, M., Evans, J., Graham, J., Ballantyne, S., McMillan, D. C., Hayes, P. C., Bird, T. G., and Stanley, A. J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Clinical Medicine
Publisher:MDPI
ISSN:2077-0383
ISSN (Online):2077-0383
Published Online:24 June 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Journal of Clinical Medicine 10(13): 2770
Publisher Policy:Reproduced under a Creative Commons License

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