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News

'Wait-and-see' policy for small hepatocellular cancer nodes

The comparable survival of alcohol injection-treated patients with early hepatocellular cancer sorted by nodular size supports the European Association for the Study of the Liver 'wait-and-see' policy with lesions less than 10 mm, finds the latest Alimentary Pharmacology & Therapeutics.

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The European Association for the Study of the Liver guidelines recommend to delay histological confirmation and treatment until small nodules, suspicious for hepatocellular carcinoma, increase in size.

Dr Andriulli and colleagues from Italy evaluated the survival of patients with cirrhosis.

The team assessed 450 cirrhotics in Child-Pugh class A or B with unifocal 'early' hepatocellular carcinoma treated by percutaneous alcohol injection.

The researchers divided the patients by nodular size into 3 groups.

Group A included 36 patients with nodules 10 mm or less, and Group B included 142 patients with nodules more than 10mm to 20 mm or less.

Mean survival was 63, 57 and 62 months in Groups A, B and C, respectively
Alimentary Pharmacology & Therapeutics

Group C included 272 patients with nodules 20mm or more to 30 mm or less.

The researchers estimated overall and tumor-free survivals by Kaplan-Meier method.

The mean follow-up for Groups A, B and C was 33, 34 and 35 months.

The team found that the mean survival time was 63, 57 and 62 months in Groups A, B and C, respectively.

The mean tumor-free survival was 44, 46 and 41 months in Groups A, B and C, respectively.

When patients were sorted by Child status, the researchers observed that mean survival time was 76 and 38 months in Child A and B.

Dr Andriulli's team concluded, “The comparable survival of percutaneous alcohol injection-treated patients with single, early hepatocellular carcinoma, sorted by nodular size supports the European Association for the Study of the Liver 'wait-and-see' policy for patients with lesions less than 10 mm.”

“This suggests that allowing the nodules to grow prior to taking further diagnostic or therapeutic actions would not harm these patients.”

Aliment Pharmacol Ther2006: 23(9): 1329
20 April 2006

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