AI Article Synopsis
- Surveillance for hepatocarcinoma (HCC) in cirrhosis patients was conducted on 141 individuals over a median of 34 months, focusing on compliance based on the cause of cirrhosis.
- Compliance rates differed significantly by cirrhosis type: high for HCV-related (97%) and "other origins" (80%), but low for alcohol-induced cases (52%), often linked to ongoing alcohol use.
- Despite the early detection of 6 small HCC lesions, outcomes were poor, with four patients dying within 3-15 months and one patient developing extensive HCC later.
Article Abstract
Surveillance for early detection of hepatocarcinoma (HCC) in patients with cirrhosis is widely accepted. In a cohort of 141 patients with cirrhosis collected during the year 1995, we conducted a surveillance program by performing liver ultrasonography and blood alpha-foetoprotein measurement every 6 months. The median follow-up was 34 months. This study addressed to two questions: the compliance to the surveillance schedule according to the aetiology of cirrhosis and the results in terms of emergence of HCC and outcome. Aetiology of cirrhosis was alcohol-induced in 86 (61%), HCV-related in 30 (21%) and from other origins in 25 (18%). Compliance to the program schedule was good in patients with HCV-related cirrhosis (29/30--97%) and patients with cirrhosis of "other origins" (20/25--80%) but was poor in patients with alcoholic cirrhosis (45/86--52%). The lack of compliance was significantly linked to the failure to achieve alcohol abstinence. During follow-up, 6 HCC lesions were observed in 6 male patients with median age of 68 years. All 6 HCC were single nodule, less than 4 cm and accessible to percutaneous acetic acid injection. Nevertheless, the outcome was disappointing, four patients dying 3-15 months later (median: 8 months), two of them with extensive HCC. One of the two patients still alive developed extensive HCC, 36 months after percutaneous acetic acid injection.
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