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Evaluating the risk of hepatocellular carcinoma in patients with prominently elevated liver stiffness measurements by FibroScan: a multicentre study

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Title: Evaluating the risk of hepatocellular carcinoma in patients with prominently elevated liver stiffness measurements by FibroScan: a multicentre study
Authors: Adler, M
Larocca, L
Trovato, FM
Marcinkowski, H
Pasha, Y
Taylor-Robinson, SD
Item Type: Journal Article
Abstract: Background and aims There are limited data on the significance of liver stiffness measurements (LSM) by transient elastography in the upper extreme end of the measurable spectrum. This multicentre retrospective observational study evaluated the risk of hepatocellular carcinoma (HCC) in patients with LSM ≥20 kPa. Methods 432 cirrhosis patients with LSM ≥20 kPa between June 2007 and October 2015 were retrospectively followed-up through electronic records. Results A minimum 1-year follow-up was available for 278 patients (177 men; average age 57, range 18–84). LSM ranged from 20.0 to 75.0 kPa (mean 34.6 kPa). Cumulative incidences of HCC were 19 (6.8%), 30 (10.8%) and 41 (14.7%) at 1, 2 and 3 years, respectively. HCC was associated with age (p = 0.003), higher LSM (p = 0.005) and viral aetiology (p = 0.007). Patients were divided into 4 groups based on LSM at entry: 20–25 kPa (n = 74); 25–30 kPa (n = 62); 30–40 kPa (n = 75); >40 kPa (n = 67). Compared to the 20–25 kPa group, the 30–40 kPa group had a hazard ratio (HR) of 3.0 (95% CI, 1.1–8.3; p = 0.037), and the >40 kPa group had a HR of 4.8 (95% CI, 1.7–13.4; p = 0.003). Conclusions This study shows an association between LSM at the upper extreme and HCC risk. Physicians may find this beneficial as a non-invasive dynamic approach to assessing HCC risk in cirrhosis patients.
Issue Date: 9-Jun-2016
Date of Acceptance: 13-May-2016
URI: http://hdl.handle.net/10044/1/39109
DOI: http://dx.doi.org/10.1016/j.hpb.2016.05.005
ISSN: 1365-182X
Publisher: Elsevier
Start Page: 678
End Page: 683
Journal / Book Title: HPB
Volume: 18
Issue: 8
Copyright Statement: © 2016 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International http://creativecommons.org/licenses/by-nc-nd/4.0/
Sponsor/Funder: Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: RDA15
Keywords: Surgery
1103 Clinical Sciences
Publication Status: Published
Appears in Collections:Division of Surgery
Faculty of Medicine



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