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The fate of indeterminate liver lesions: What proportion are precursors of hepatocellular carcinoma?

Cococcia, Sara; Dutta, Priti; Moghim, Melika; Hogan, Brian; Tanwar, Sudeep; Marshall, Aileen; Macdonald, Douglas; ... Trembling, Paul M; + view all (2022) The fate of indeterminate liver lesions: What proportion are precursors of hepatocellular carcinoma? BMC Gastroenterology , 22 (1) , Article 118. 10.1186/s12876-022-02135-x. Green open access

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Abstract

BACKGROUND: The natural history and incidence of hepatocellular carcinoma (HCC) arising from indeterminate liver lesions are not well described. We aimed to define the incidence of HCC in a cohort of patients undergoing surveillance by magnetic resonance imaging (MRI) and estimate any associations with incident HCC. METHODS: We performed a retrospective follow-up study, identifying MRI scans in which indeterminate lesions had been reported between January 2006 and January 2017. Subsequent MRI scan reports were reviewed for incident HCC arising from indeterminate lesions, data were extracted from electronic patient records and survival analysis performed to estimate associations with baseline factors. RESULTS: One hundred and nine patients with indeterminate lesions on MRI were identified. HCC developed in 19 (17%) patients over mean follow up of 4.6 years. Univariate Cox proportional hazards analysis found incident HCC to be significantly associated with baseline low platelet count (hazard ratio (HR) = 7.3 (95% confidence intervals (CI) 2.1-24.9), high serum alpha-fetoprotein level (HR = 2.7 (95% CI 1.0-7.1)) and alcohol consumption above fourteen units weekly (HR = 3.1 (95% CI 1.1-8.7)). Multivariate analysis, however, found that only low platelet count was independently associated with HCC (HR = 5.5 (95% CI 0.6-5.1)). CONCLUSIONS: HCC arises in approximately one fifth of indeterminate liver lesions over 4.6 years and is associated with a low platelet count at the time of first diagnosis of an indeterminate lesion. Incidence of HCC was more common in people with viral hepatitis and in those consuming > 14 units of alcohol per week. Our data may be used to support a strategy of enhanced surveillance in patients with indeterminate lesions.

Type: Article
Title: The fate of indeterminate liver lesions: What proportion are precursors of hepatocellular carcinoma?
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s12876-022-02135-x
Publisher version: https://doi.org/10.1186/s12876-022-02135-x
Language: English
Additional information: © 2022 BioMed Central Ltd. This article is licensed under a Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/).
Keywords: Hepatocellular carcinoma, Liver cirrhosis, Liver neoplasms, Magnetic resonance imaging, Carcinoma, Hepatocellular, Follow-Up Studies, Humans, Liver Neoplasms, Magnetic Resonance Imaging, Retrospective Studies
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10145569
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