Poor adherence to hepatocellular carcinoma surveillance: A systematic review and meta‐analysis of a complex issue

Zhao, Changqing; Jin, Mingjuan; Le, Richard H.; Le, Michael; Chen, Vincent; Jin, Michelle; Wong, Grace Lai–Hung; Wong, Vincent Wai‐Sun; Lim, Young‐Suk; Chuang, Wan‐Long; Yu, Ming‐Lung; Nguyen, Mindie H.

doi:10.1111/liv.13555

Cited by 73 publications

(61 citation statements)

References 53 publications

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“…The small size of our patient group does not allow for a significant study of the correlation between etiology of liver disease and compliance. However, literature seems to suggest low adherence in patients with chronic hepatitis, which may be a factor in long delays of follow-up imaging studies (10). As such, calculated mean time to the appearance of tumoral recurrence may be considerably decreased by shorter times to follow-up in patients treated for HCC (11).…”

Section: Discussion Discussionmentioning

confidence: 99%

Lipiodol Uptake and Wash-out Rate Detection on Computed Tomography as Predictors for Tumor Recurrence in Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization

Scheau¹,

Scheau²,

Lupescu³

2017

SGO

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Background: Transcatheter arterial chemoembolization (TACE) is a dedicated method for treating intermediate stage hepatocellular carcinoma (HCC). The Lipiodol used in conventional TACE presents the advantage of being easily visualized and quantified on Computed Tomography (CT). Methods: Immediate postprocedural (baseline) and follow-up CT examinations of twenty patients treated by TACE for HCC were evaluated in this study. Lipiodol uptake on baseline images and progressive washout on follow-up examinations were assessed. Results: Statistically significant lower baseline Lipiodol densities are found in patients that develop tumoral recurrence at some point on follow-up examinations (p=0.0280). Using the treated nodule density as a predictive factor for tumoral recurrence, we obtained a diagnostic sensitivity of 92.31% in patients with cut-off values ≤ 545.36 HU, albeit with a low specificity. All patients develop a quantifiable Lipiodol density decrease over time, regardless of tumoral recurrence implication (p=0.0298). There is evidence to suggest that specific Lipiodol accumulation patterns may be associated with a higher risk of tumor recurrence. Conclusions: Baseline post-procedural Lipiodol accumulation levels may serve as a predictor for tumoral recurrence in patients treated for HCC using TACE, with good sensitivity provided a high cut-off value is set for the measured densities.

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Section: Discussion Discussionmentioning

confidence: 99%

Lipiodol Uptake and Wash-out Rate Detection on Computed Tomography as Predictors for Tumor Recurrence in Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization

Scheau¹,

Scheau²,

Lupescu³

2017

SGO

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“…In addition, HCC surveillance may help detect early incidence or recurrence after liver resection and consequently improve patients' survival outcomes. However, HCC surveillance is not properly conducted and requires improvement [50,51]. Selecting a target patient group instead of all patients for surveillance may be a suitable strategy, but few studies have been designed to obtain such a criterion [52].…”

Section: Discussionmentioning

confidence: 99%

Identifying Differentially Expressed MicroRNAs Between Cirrhotic and Non-Cirrhotic Hepatocellular Carcinoma and Exploring Their Functions Using Bioinformatic Analysis

Mei¹,

You²,

Jin³

et al. 2018

Cell Physiol Biochem

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Background/Aims: Few studies have been designed to directly investigate the exact mechanisms underlying the different phenotypes between cirrhotic and non-cirrhotic hepatocellular carcinoma (HCC). This study aimed to illuminate the incidence and developmental mechanisms for both types of HCC through differentially expressed microRNAs (miRNAs) using bioinformatic analysis. Methods: The miRNA-seq data and clinical data of patients (from The Cancer Genome Atlas (TCGA) database) were utilized to determine differentially expressed miRNAs between cirrhotic and non-cirrhotic HCC. Afterwards, the function of the selected miRNAs was predicted with online tools. Furthermore, the miRNA expression and clinical significance were validated by external datasets and our experiment. Results: The present study included 135 non-cirrhotic and 80 cirrhotic patients to find differentially expressed miRNAs. Among them, four miRNAs (mir-1296, mir-23c, mir-149, and mir-95) were finally selected for further validation and analysis. Correlation analysis found that two miRNAs are greatly associated with the non-cirrhotic HCC patients’ clinical traits, such as the T, M, and N tumor stages. However, only mir-23c was associated with the cirrhotic HCC patients’ tumor T and N stages. Furthermore, survival analysis revealed that increased mir-149 in non-cirrhotic HCC, patients’ age and the existence of vessels in the tumor in cirrhotic HCC were independent risk factors for the patients’ postoperative overall survival. Functional and interaction analyses also supported the notion that these miRNAs function through some pathways that influence the behavior of the HCC. These results are strongly supported by analysis of extra datasets and our experiment. Conclusions: The cirrhotic and non-cirrhotic HCC types involve differentially expressed miRNAs, which are correlated with distinctive pathological traits. To some extent, non-cirrhotic HCC seems more dependent on miRNA network regulation, but additional studies are needed to confirm this conclusion.

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“…Watchful follow‐up for patients who have pre‐HCC is widely accepted in current clinical practice, though precise surveillance strategy remains to be established and it might be limited by high‐cost imaging tests and poor compliance of patients. ( ) Meanwhile, the efficacy of active interventions, such as surgery and local percutaneous therapy for pre‐HCC disease, is still unknown, so further studies about the treatment of pre‐HCC are needed.…”

Section: Treatment Of Pre‐hcc Diseasementioning

confidence: 99%

A New Concept: Pre‐HCC Disease

Yao¹,

Feng²,

Zhao³

et al. 2018

Hepatology

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Poor adherence to hepatocellular carcinoma surveillance: A systematic review and meta‐analysis of a complex issue

Abstract: Overall adherence rate to HCC surveillance was suboptimal at 52% with no significant differences by liver disease aetiology or study location in multivariate meta-regression analysis. Further research and educational efforts are needed to improve the current rate of HCC surveillance.

Cited by 73 publications

References 53 publications

Lipiodol Uptake and Wash-out Rate Detection on Computed Tomography as Predictors for Tumor Recurrence in Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization

Lipiodol Uptake and Wash-out Rate Detection on Computed Tomography as Predictors for Tumor Recurrence in Hepatocellular Carcinoma Treated by Transcatheter Arterial Chemoembolization

Identifying Differentially Expressed MicroRNAs Between Cirrhotic and Non-Cirrhotic Hepatocellular Carcinoma and Exploring Their Functions Using Bioinformatic Analysis

A New Concept: Pre‐HCC Disease

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