MedicalResearch.com Interview with:
Amit Singal MD MS
David Bruton Jr. Professor in Clinical Cancer Research
Associate Professor of Medicine
Medical Director of Liver Tumor Program
Clinical Chief of Hepatology
University of Texas Southwestern
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Hepatocellular carcinoma, the most common form of primary liver cancer, often has a very poor prognosis because most cancers are found at a late stage when curative treatment is not available. However, if the cancer is found early, curative therapies are possible and patients can typically live longer than 5 years.
There is currently debate how at-risk patients with chronic liver disease should be screened – with an abdominal ultrasound alone or using a combination of abdominal ultrasound and a blood test called alpha fetoprotein. Many professional societies have traditionally recommended the former, i.e. ultrasound alone, given few data showing a benefit of adding alpha fetoprotein.
Our study examines all available literature examining this question and found using the two tests in combination significantly increases the likelihood of finding the cancer at an early stage. Whereas abdominal ultrasound misses over half of all cancers, using it in combination with alpha fetoprotein can detect two-thirds of cancers at an early stage.
MedicalResearch.com: What should readers take away from your report?
Response: We feel the results from our study should change the way we screen for hepatocellular carcinoma in at-risk patients with chronic liver disease. These patients should undergo abdominal ultrasound in combination with the blood test, alpha fetoprotein, every 6 months to maximize the chance at finding hepatocellular carcinoma at an early stage. This is critical to performing curative treatment and improving survival.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our study examines alpha fetoprotein, the blood test that has been best evaluated for hepatocellular carcinoma screening. However, other blood tests are being evaluated to see if we can improve screening performance even more, and future research is needed to bring these biomarkers to market.
MedicalResearch.com: Is there anything else you would like to add?
Response: We have previously shown that many at-risk patients do not receive any screening. While our study is important to inform how best to do hepatocellular carcinoma screening, we still stress that the best test is the one that gets done. Increasing utilization of screening is one of the most important things we need to do to improve hepatocellular carcinoma prognosis.
My disclosures relevant to this research include being on advisory boards for Wako Diagnostics and Roche.
Surveillance Imaging and Alpha Fetoprotein for Early Detection of Hepatocellular Carcinoma in Patients With Cirrhosis: A Meta-analysis
Kristina Tzartzeva, Joseph Obi, Nicole E. Rich, Neehar D. Parikh, Jorge A. Marrero,
Adam Yopp, Akbar Waljee, Amit G. Singal1, 4,
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