Hepatocellular carcinoma occurs with increased frequency in patients with primary biliary cirrhosis.
Effectiveness of surveillance recommendations for hepatocellular carcinoma is controversial, and data are lacking in patients with primary biliary cirrhosis .
Dr Marina Silveira and colleagues from the United Kingdom established the importance of surveillance for hepatocellular carcinoma in patients with primary biliary cirrhosis.
In addition, the team of doctors identified a target population of patients with primary biliary cirrhosis for hepatocellular carcinoma surveillance.
|Patients in the surveillant population had improved survival|
The doctors proposed surveillance recommendations for patients with primary biliary cirrhosis.
The team retrospectively identified 36 patients seen at the Mayo Clinic between 1976 and 2007 with a diagnosis of both primary biliary cirrhosis and hepatocellular carcinoma.
The doctors noted that 5 patients were diagnosed incidentally, 17 patients comprised our surveillant population, and 14 patients were diagnosed outside a surveillance program.
Patients in the surveillant population were more likely to undergo therapy, and had improved survival compared with the nonsurveillant population.
All cases of hepatocellular carcinoma except one where they were predicted to be at significant risk based on age, sex, evidence of portal hypertension, and history of blood transfusion using a previous predictive model.
Dr Silveira’s team concluded, “We established the importance of surveillance for hepatocellular carcinoma in patients with primary biliary cirrhosis.”
“We demonstrated adequate performance of a predictive model and propose it should be refined.”
“It can be used to identify patients with primary biliary cirrhosis who should be screened for development of hepatocellular carcinoma.”
“Further studies are needed so that optimal hepatocellular carcinoma surveillance recommendations in this population can be determined and included in the practice guidelines for primary biliary cirrhosis.”