Patients with Alcoholic Cirrhosis at Low Risk for HCC; Surveillance Not Warranted
(ChemotherapyAdvisor) – A cohort study of Danish patients with alcoholic cirrhosis suggests that because they are at low risk for hepatocellular carcinoma (HCC), “surveillance would be expected to have a minimal effect on mortality and is unlikely to be cost effective,” according to a study in the June 19 issue of Annals of Internal Medicine.
The role of surveillance in patients with alcoholic cirrhosis remains undefined, noted Peter Jepsen, MD, PhD, of Aarhus University Hospital, Aarhus, Denmark, and colleagues. Using a nationwide registry of all Danish citizens with a first-time hospital diagnosis of alcoholic cirrhosis from 1993 to 2005, they measured HCC incidence and mortality one year following this diagnosis as well as ratio of HCC-related mortality to total mortality.
Of 8,482 patients, 169 developed HCC and, of the 5,734 patients who died, 151 had developed HCC. The five-year cumulative risk of HCC was 1.0% (95% CI, 0.8%–1.3%) and the five-year cumulative mortality, 43.7% (CI, 42.6%–44.7%). “Only 1.8% of all deaths were HCC-related,” they reported. “In sensitivity analyses that included all possible HCC diagnoses and a subpopulation of patients who were followed by hepatologists, the highest five-year HCC risk was 1.9% (CI, 0.8%–3.9%).” This mortality rate was no greater than that of the nationwide cohort.