Hepatocellular cancer: Difference between revisions
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imported>Robert Badgett No edit summary |
imported>Robert Badgett (started screening) |
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==Diagnosis== | ==Diagnosis== | ||
The [[alpha-fetoprotein]] may be elevated; however, its [[positive predictive value]] is low and it may be elevated in patients with [[cirrhosis]].<ref name="pmid11350553">{{cite journal| author=Tong MJ, Blatt LM, Kao VW| title=Surveillance for hepatocellular carcinoma in patients with chronic viral hepatitis in the United States of America. | journal=J Gastroenterol Hepatol | year= 2001 | volume= 16 | issue= 5 | pages= 553-9 | pmid=11350553 | The [[alpha-fetoprotein]] may be elevated; however, its [[positive predictive value]] is low and it may be elevated in patients with [[cirrhosis]].<ref name="pmid11350553">{{cite journal| author=Tong MJ, Blatt LM, Kao VW| title=Surveillance for hepatocellular carcinoma in patients with chronic viral hepatitis in the United States of America. | journal=J Gastroenterol Hepatol | year= 2001 | volume= 16 | issue= 5 | pages= 553-9 | pmid=11350553 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=11350553 }} | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&email=badgett@uthscdsa.edu&retmode=ref&cmd=prlinks&id=11350553 }}</ref> | ||
==Treatment== | ==Treatment== | ||
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===Staging information=== | ===Staging information=== | ||
{{PDQ-staging|http://www.cancer.gov/cancertopics/pdq/treatment/adult-primary-liver/HealthProfessional/page4}} | {{PDQ-staging|http://www.cancer.gov/cancertopics/pdq/treatment/adult-primary-liver/HealthProfessional/page4}} | ||
==Screening== | |||
"In a mixed-aetiology cohort, the most effective surveillance strategy is to screen each patient with AFP assay and ultrasound imaging on a 6-monthly basis" according to a [[systematic review]] by the [http://www.hta.ac.uk/ NIHR Health Technology Assessment programme] (UK). <ref name="pmid17767898">{{cite journal| author=Thompson Coon J, Rogers G, Hewson P, Wright D, Anderson R, Cramp M et al.| title=Surveillance of cirrhosis for hepatocellular carcinoma: systematic review and economic analysis. | journal=Health Technol Assess | year= 2007 | volume= 11 | issue= 34 | pages= 1-206 | pmid=17767898 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17767898 }} </ref> | |||
In a [[randomized controlled trial]], the [[relative risk ratio]] of [[biannual alpha-fetoprotein and ultrasonography]], as compared to [[no screening]], for mortality from hepatocellular carcinoma was 0.6 and the [[relative risk reduction]] was 36.7%. In populations similar to those in this study which had a rate of risk as measured by the mortality from hepatocellular carcinoma of 0.1315% without treatment, the [[number needed to treat]] is 2070. <ref name="pmid15042359">{{cite journal| author=Zhang BH, Yang BH, Tang ZY| title=Randomized controlled trial of screening for hepatocellular carcinoma. | journal=J Cancer Res Clin Oncol | year= 2004 | volume= 130 | issue= 7 | pages= 417-22 | pmid=15042359 | doi=10.1007/s00432-004-0552-0 | pmc= | url= }} </ref> | |||
==References== | ==References== | ||
<references/> | <references/> | ||
Revision as of 07:28, 12 August 2011
Diagnosis
The alpha-fetoprotein may be elevated; however, its positive predictive value is low and it may be elevated in patients with cirrhosis.[1]
Treatment
Hepatocellular cancer treatment information from the National Cancer Institute's Physician Data Query
Prognosis
Staging information
Hepatocellular cancer staging information from the National Cancer Institute's Physician Data Query
Screening
"In a mixed-aetiology cohort, the most effective surveillance strategy is to screen each patient with AFP assay and ultrasound imaging on a 6-monthly basis" according to a systematic review by the NIHR Health Technology Assessment programme (UK). [2]
In a randomized controlled trial, the relative risk ratio of biannual alpha-fetoprotein and ultrasonography, as compared to no screening, for mortality from hepatocellular carcinoma was 0.6 and the relative risk reduction was 36.7%. In populations similar to those in this study which had a rate of risk as measured by the mortality from hepatocellular carcinoma of 0.1315% without treatment, the number needed to treat is 2070. [3]
References
- ↑ Tong MJ, Blatt LM, Kao VW (2001). "Surveillance for hepatocellular carcinoma in patients with chronic viral hepatitis in the United States of America.". J Gastroenterol Hepatol 16 (5): 553-9. PMID 11350553.
- ↑ Thompson Coon J, Rogers G, Hewson P, Wright D, Anderson R, Cramp M et al. (2007). "Surveillance of cirrhosis for hepatocellular carcinoma: systematic review and economic analysis.". Health Technol Assess 11 (34): 1-206. PMID 17767898. [e]
- ↑ Zhang BH, Yang BH, Tang ZY (2004). "Randomized controlled trial of screening for hepatocellular carcinoma.". J Cancer Res Clin Oncol 130 (7): 417-22. DOI:10.1007/s00432-004-0552-0. PMID 15042359. Research Blogging.