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Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit
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Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit
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Journal Article
Biopsy for advanced hepatocellular carcinoma: results of a multicentre UK audit
2021
Overview
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
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Adult
/ Aged
/ Biomedical and Life Sciences
/ Biopsy
/ Biopsy - statistics & numerical data
/ Carcinoma, Hepatocellular - diagnostic imaging
/ Carcinoma, Hepatocellular - drug therapy
/ Carcinoma, Hepatocellular - pathology
/ Humans
/ Liver Neoplasms - diagnostic imaging
/ Liver Neoplasms - drug therapy
/ Magnetic Resonance Imaging - statistics & numerical data
/ Male
/ Oncology
/ Patients
