Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit

Childs, Alexa, Zakeri, Nekisa, Ma, Yuk Ting, O'Rourke, Joanne, Ross, Paul, Hashem, Essam, Hubner, Richard A, Hockenhull, Kimberley, Iwuji, Chinenye, Khan, Sam
et al (show 9 more authors) (2021) Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit. BRITISH JOURNAL OF CANCER, 125 (10). pp. 1350-1355.

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<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>The diagnostic biopsy is safe and feasible for most patients eligible for systemic therapy.

Item Type: Article
Uncontrolled Keywords: Humans, Carcinoma, Hepatocellular, Cholangiocarcinoma, Liver Neoplasms, Tomography, X-Ray Computed, Magnetic Resonance Imaging, Biopsy, Prospective Studies, Predictive Value of Tests, Adult, Aged, Aged, 80 and over, Middle Aged, Male, Young Adult, United Kingdom
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 18 Jan 2022 09:33
Last Modified: 18 Jan 2023 21:15
DOI: 10.1038/s41416-021-01535-2
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