Semiannual Ultrasound Improves Liver Cancer Outcome

Ultrasound surveillance for hepatocellular carcinoma may improve clinical outcome at a reasonable cost in cirrhotic patients

TUESDAY, Dec. 23 (HealthDay News) -- Semiannual surveillance for hepatocellular carcinoma using ultrasound in patients with liver cirrhosis leads to improved clinical outcomes, researchers report in the December issue of Clinical Gastroenterology and Hepatology.

Karin L. Andersson, M.D., of Massachusetts General Hospital in Boston, and colleagues used a computer-based state transition model to compare six unique surveillance strategies with no surveillance for hepatocellular carcinoma in cirrhotic patients aged 50 and older. The investigators calculated the number of screening tests needed to detect one small hepatocellular carcinoma tumor, as well as the related costs of the screening procedures.

Compared with no surveillance, semiannual surveillance with ultrasound extended the overall quality-adjusted life expectancy by an average 8.6 months, the investigators found. Importantly, quality-adjusted life years were extended by 3.5 years in patients with detected and treated hepatocellular carcinoma, the researchers report. This semiannual ultrasound surveillance was calculated to have an incremental cost-effectiveness ratio of $30,700 per quality-adjusted life year, lower than the benchmark of $50,000 per quality-adjusted life year generally used in the United States, the authors note.

"The results of our study predict that surveillance for early hepatocellular carcinoma improves clinical outcomes," Andersson and colleagues write, adding that these findings "support recent American Association for the Study of Liver Diseases guidelines recommending surveillance with ultrasound alone."

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