Hepatocellular Carcinoma Surveillance: Evidence-Based Tailored Approach

Eden Koo; Amit G Singal

doi:10.1016/j.soc.2023.06.005

Hepatocellular Carcinoma Surveillance: Evidence-Based Tailored Approach

Surg Oncol Clin N Am. 2024 Jan;33(1):13-28. doi: 10.1016/j.soc.2023.06.005. Epub 2023 Aug 1.

Authors

Eden Koo¹, Amit G Singal²

Affiliations

¹ Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA.
² Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA; Division of Digestive and Liver Diseases, Department of Internal Medicine, UT Southwestern Medical Center, 5959 Harry Hines Boulevard, POB 1, Suite 420, Dallas, TX 75390-8887, USA. Electronic address: amit.singal@utsouthwestern.edu.

PMID: 37945138
DOI: 10.1016/j.soc.2023.06.005

Abstract

Hepatocellular carcinoma (HCC) surveillance is recommended by professional society guidelines given a consistent association with reduced HCC-related mortality. HCC surveillance should be performed using semiannual abdominal ultrasound and alpha-fetoprotein, although this combination has suboptimal sensitivity and can miss more than one-third of HCC at an early stage. There are promising emerging blood-based and imaging-based strategies, including abbreviated MRI and biomarker panels; however, these require further validation before routine use in clinical practice. HCC surveillance is underused in clinical practice due to patient-related and provider-related barriers, highlighting a need for interventions to improve surveillance utilization in clinical practice.

Keywords: Alpha fetoprotein; Biomarkers; Early detection; Liver cancer; Screening; Ultrasound.

Publication types

Review

MeSH terms

Carcinoma, Hepatocellular* / diagnostic imaging
Humans
Liver Neoplasms* / diagnosis
Liver Neoplasms* / epidemiology
Ultrasonography