Surveillance for Hepatocellular Carcinoma: Current Best Practice and Future Direction
Hepatocellular cancer (HCC) is the fourth leading cause of cancer-related deaths worldwide and the fastest growing cause of cancer deaths in the United States. The overall prognosis of HCC remains dismal, except for the subset of patients who are diagnosed at early stage and receive potentially cura...
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| Published in | Gastroenterology (New York, N.Y. 1943) Vol. 157; no. 1; pp. 54 - 64 |
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| Main Authors | , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.07.2019
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| Subjects | |
| Online Access | Get full text |
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| Abstract | Hepatocellular cancer (HCC) is the fourth leading cause of cancer-related deaths worldwide and the fastest growing cause of cancer deaths in the United States. The overall prognosis of HCC remains dismal, except for the subset of patients who are diagnosed at early stage and receive potentially curative therapies, such as surgical resection and liver transplantation. Given this, expert society guidelines recommend HCC surveillance every 6 months in at-risk individuals. Despite these recommendations, the effectiveness of HCC surveillance remains a subject of debate. We discuss current best practices for HCC surveillance and the evidence that support these recommendations. We also describe several initiatives that are underway to improve HCC surveillance and outline areas that may serve as high-yield targets for future research. Overall, we believe these efforts will help the field move toward precision surveillance, where surveillance tests and intervals are tailored to individual HCC risk. Doing so can maximize surveillance benefits, minimize surveillance harms, and optimize overall value for all patients. |
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| AbstractList | Hepatocellular cancer (HCC) is the fourth leading cause of cancer-related deaths worldwide and the fastest growing cause of cancer deaths in the United States. The overall prognosis of HCC remains dismal, except for the subset of patients who are diagnosed at early stage and receive potentially curative therapies, such as surgical resection and liver transplantation. Given this, expert society guidelines recommend HCC surveillance every 6 months in at-risk individuals. Despite these recommendations, the effectiveness of HCC surveillance remains a subject of debate. We discuss current best practices for HCC surveillance and the evidence that support these recommendations. We also describe several initiatives that are underway to improve HCC surveillance and outline areas that may serve as high-yield targets for future research. Overall, we believe these efforts will help the field move toward precision surveillance, where surveillance tests and intervals are tailored to individual HCC risk. Doing so can maximize surveillance benefits, minimize surveillance harms, and optimize overall value for all patients.Hepatocellular cancer (HCC) is the fourth leading cause of cancer-related deaths worldwide and the fastest growing cause of cancer deaths in the United States. The overall prognosis of HCC remains dismal, except for the subset of patients who are diagnosed at early stage and receive potentially curative therapies, such as surgical resection and liver transplantation. Given this, expert society guidelines recommend HCC surveillance every 6 months in at-risk individuals. Despite these recommendations, the effectiveness of HCC surveillance remains a subject of debate. We discuss current best practices for HCC surveillance and the evidence that support these recommendations. We also describe several initiatives that are underway to improve HCC surveillance and outline areas that may serve as high-yield targets for future research. Overall, we believe these efforts will help the field move toward precision surveillance, where surveillance tests and intervals are tailored to individual HCC risk. Doing so can maximize surveillance benefits, minimize surveillance harms, and optimize overall value for all patients. Hepatocellular cancer (HCC) is the fourth leading cause of cancer-related deaths worldwide and the fastest growing cause of cancer deaths in the United States. The overall prognosis of HCC remains dismal, except for the subset of patients who are diagnosed at early stage and receive potentially curative therapies, such as surgical resection and liver transplantation. Given this, expert society guidelines recommend HCC surveillance every 6 months in at-risk individuals. Despite these recommendations, the effectiveness of HCC surveillance remains a subject of debate. We discuss current best practices for HCC surveillance and the evidence that support these recommendations. We also describe several initiatives that are underway to improve HCC surveillance and outline areas that may serve as high-yield targets for future research. Overall, we believe these efforts will help the field move toward precision surveillance, where surveillance tests and intervals are tailored to individual HCC risk. Doing so can maximize surveillance benefits, minimize surveillance harms, and optimize overall value for all patients. |
| Author | Kanwal, Fasiha Singal, Amit G. |
| AuthorAffiliation | 4 Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas 1 Sections of Gastroenterology and Hepatology, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas 2 Health Services Research, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas 3 Center of Innovation, Effectiveness and Quality, Houston, Texas |
| AuthorAffiliation_xml | – name: 2 Health Services Research, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas – name: 4 Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas – name: 1 Sections of Gastroenterology and Hepatology, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas – name: 3 Center of Innovation, Effectiveness and Quality, Houston, Texas |
| Author_xml | – sequence: 1 givenname: Fasiha surname: Kanwal fullname: Kanwal, Fasiha email: kanwal@bcm.edu organization: Sections of Gastroenterology and Hepatology, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas – sequence: 2 givenname: Amit G. surname: Singal fullname: Singal, Amit G. organization: Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, Texas |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30986389$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | 2019 AGA Institute Copyright © 2019 AGA Institute. Published by Elsevier Inc. All rights reserved. |
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| Snippet | Hepatocellular cancer (HCC) is the fourth leading cause of cancer-related deaths worldwide and the fastest growing cause of cancer deaths in the United States.... |
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| SubjectTerms | alpha-Fetoproteins - metabolism Carcinoma, Hepatocellular - diagnosis Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - metabolism Early Detection of Cancer - methods Hepatitis B, Chronic - epidemiology Humans Liver Cirrhosis - epidemiology Liver Neoplasms - diagnosis Liver Neoplasms - epidemiology Liver Neoplasms - metabolism Magnetic Resonance Imaging Plant Lectins Practice Guidelines as Topic Risk Assessment Tomography, X-Ray Computed Ultrasonography |
| Title | Surveillance for Hepatocellular Carcinoma: Current Best Practice and Future Direction |
| URI | https://www.clinicalkey.com/#!/content/1-s2.0-S0016508519356951 https://dx.doi.org/10.1053/j.gastro.2019.02.049 https://www.ncbi.nlm.nih.gov/pubmed/30986389 https://www.proquest.com/docview/2210332322 https://pubmed.ncbi.nlm.nih.gov/PMC6636644 |
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