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Hepatocellular Carcinoma Surveillance—Experience from Croatian Referral Centre for Chronic Liver Diseases

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Abstract

Purpose

For patients at high-risk of developing hepatocellular carcinoma (HCC), biannual ultrasound surveillance has long been recommended, in order to detect the tumor in the early, potentially curative stages. However, globally reported HCC surveillance rates vary greatly, ranging from as low as 1.7 to as high as 80%. Our aim was to assess the utilization of surveillance with biannual ultrasound in high-risk Croatian patients and to identify the factors that impact the implementation of the recommended protocol.

Methods

This retrospective study included 145 newly diagnosed HCC patients in the period from January 2010 to September 2015. We identified low-risk and high-risk patients. The latter were further subdivided into the regular biannual ultrasound surveillance group and the non-surveillance group. The groups were compared according to demographic characteristics and BCLC stage at the time of HCC diagnosis.

Results

Among 145 patients, 80 patients were classified as high-risk according to EASL criteria. During the relevant period, 28.7% underwent regular surveillance, while 71.25% did not. Younger patients were more likely to undergo surveillance (OR 0.935 CI 0.874–0.999; p = 0.05). The patients who underwent regular surveillance had a higher chance of being diagnosed at a curative stage (BCLC 0 or A) (OR 3.701 CI 1.279–10.710; p < 0.05).Gender was not a predictor of participation in the regular surveillance protocol. Among the high-risk patients who did not undergo regular surveillance, 56.1% were not aware of the chronic liver disease prior to the HCC diagnosis.

Conclusion

HCC surveillance is still underutilized in high-risk Croatian patients despite its obvious benefits possibly due to the untimely diagnosis of the chronic liver disease.

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Acknowledgments

This study was conducted as an original study at the Department of Gastroenterology, University Hospital Centre Zagreb, which is a referral center for treatment of chronic liver diseases.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia

    Matea Majerović, Mislav Jelaković, Marina Premužić, Ivana Knežević Štromar, Davor Radić, Rajko Ostojić, Nadan Rustemović & Zeljko Krznarić

  2. Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia

    Marko Mance

  3. Department of Oncology, University Hospital Centre Zagreb, Zagreb, Croatia

    Stjepko Pleština

Authors
  1. Matea Majerović
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  2. Mislav Jelaković
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  3. Marina Premužić
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  4. Ivana Knežević Štromar
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  5. Davor Radić
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  6. Marko Mance
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  7. Stjepko Pleština
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  8. Rajko Ostojić
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  9. Nadan Rustemović
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  10. Zeljko Krznarić
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Corresponding author

Correspondence to Mislav Jelaković.

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This study was approved by the ethics committee of the University Hospital Centre Zagreb (approval number—02/21 AG) and was conducted in compliance with the Helsinki Declaration.

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Majerović, M., Jelaković, M., Premužić, M. et al. Hepatocellular Carcinoma Surveillance—Experience from Croatian Referral Centre for Chronic Liver Diseases. J Gastrointest Canc 50, 48–53 (2019). https://doi.org/10.1007/s12029-017-0011-1

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