Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit.
Author
Childs, AlexaZakeri, Nekisa
Ma, Yuk Ting
O'Rourke, Joanne
Ross, Paul
Hashem, Essam
Hubner, Richard A
Hockenhull, Kimberley
Iwuji, Chinenye
Khan, Sam
Palmer, Daniel H
Connor, Joanna
Swinson, Daniel
Darby, Suzanne
Braconi, Chiara
Roques, Tom
Yu, Dominic
Luong, Tu Vinh
Meyer, Tim
Publication date
2021-09-15
Metadata
Show full item recordAbstract
Background: 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.Citation
Childs A, Zakeri N, Ma YT, O'Rourke J, Ross P, Hashem E, Hubner RA, Hockenhull K, Iwuji C, Khan S, Palmer DH, Connor J, Swinson D, Darby S, Braconi C, Roques T, Yu D, Luong TV, Meyer T. Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit. Br J Cancer. 2021 Nov;125(10):1350-1355. doi: 10.1038/s41416-021-01535-2. Epub 2021 Sep 15.Type
ArticleAdditional Links
https://pubmed.ncbi.nlm.nih.gov/34526664/PMID
34526664Journal
British Journal of CancerPublisher
Springer Natureae974a485f413a2113503eed53cd6c53
10.1038/s41416-021-01535-2