Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit
Ma, Y. T.
Hubner, Richard A
Palmer, D. H.
Luong, T. V.
AffiliationDepartment of Oncology, Royal Free London NHS Foundation Trust, London, UK
MetadataShow full item record
AbstractBackground: Advanced hepatocellular carcinoma (HCC) is commonly diagnosed using non-invasive radiological criteria (NIRC) defined by the European Association for the Study of the Liver or the American Association for the Study of Liver Diseases. In 2017, The National Institute for Clinical Excellence mandated histological confirmation of disease to authorise the use of sorafenib in the UK. Methods: This was a prospective multicentre audit in which patients suitable for sorafenib were identified at multidisciplinary meetings. The primary analysis cohort (PAC) was defined by the presence of Child-Pugh class A liver disease and performance status 0-2. Clinical, radiological and histological data were reported locally and collected on a standardised case report form. Results: Eleven centres reported 418 cases, of which 361 comprised the PAC. Overall, 76% had chronic liver disease and 66% were cirrhotic. The diagnostic imaging was computed tomography in 71%, magnetic resonance imaging in 27% and 2% had both. Pre-existing histology was available in 45 patients and 270 underwent a new biopsy, which confirmed HCC in 93.4%. Alternative histological diagnoses included cholangiocarcinoma (CC) and combined HCC-CC. In cirrhotic patients, NIRC criteria had a sensitivity of 65.4% and a positive predictive value of 91.4% to detect HCC. Two patients (0.7%) experienced mild post-biopsy bleeding. Conclusion: The diagnostic biopsy is safe and feasible for most patients eligible for systemic therapy.
CitationChilds A, Zakeri N, Ma YT, O’Rourke J, Ross P, Hashem E, et al. Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit. Br J Cancer. 2021 Sep 15.
JournalBritish Journal of Cancer
- Sorafenib for the treatment of advanced hepatocellular carcinoma.
- Authors: Connock M, Round J, Bayliss S, Tubeuf S, Greenheld W, Moore D
- Issue date: 2010 May
- Suicidal Ideation
- Authors: Harmer B, Lee S, Duong TvH, Saadabadi A
- Issue date: 2021 Jan
- Selective internal radiation therapies for unresectable early-, intermediate- or advanced-stage hepatocellular carcinoma: systematic review, network meta-analysis and economic evaluation.
- Authors: Walton M, Wade R, Claxton L, Sharif-Hurst S, Harden M, Patel J, Rowe I, Hodgson R, Eastwood A
- Issue date: 2020 Sep
- Liver transplantation in cirrhotic patients with small hepatocellular carcinoma: an analysis of pre-operative imaging, explant histology and prognostic histologic indicators.
- Authors: Bhattacharjya S, Bhattacharjya T, Quaglia A, Dhillon AP, Burroughs AK, Patch DW, Tibballs JM, Watkinson AF, Rolles K, Davidson BR
- Issue date: 2004
- Diagnostic sensitivity of hepatocellular carcinoma imaging and its application to non-cirrhotic patients.
- Authors: Lin MT, Chen CL, Wang CC, Cheng YF, Eng HL, Wang JH, Chiu KW, Lee CM, Hu TH
- Issue date: 2011 Apr