Factors Associated with Surveillance for Early Detection of Hepatocellular Carcinoma in Liver Cirrhosis Patients

Ario Perbowo Putra, Andri Sanityoso Sulaiman, Juferdy Kurniawan, Kuntjoro Harimurti


Background: The minimal number of hepatocellular carcinoma (HCC) patients diagnosed through surveillance is proposed as the cause of persistently low number of survival. It is important to identify the proportion of surveillance for early detection of HCC in patients with liver cirrhosis and related factors. This study aimed to determine the proportion of surveillance for early detection of HCC in patients with liver cirrhosis and related factors.

Method: A cross-sectional study of patients with liver cirrhosis at RSCM from January to December 2013. The data was obtained from medical records and confirmed by telephone. Surveillance was required for abdominal ultrasound with or without AFP at least once a year within 3 years after that period. Factors studied were gender, ethnicity, education level, income level, availability of medical insurance, location of residence, surveillance education, cirrhosis aetiology, and severity of cirrhosis. Then, logistic regression test was used in the multivariate analysis.

Results: From 200 patients, 50 patients (25,0%) underwent surveillance, 150 patients (75,0%) did not. Bivariate analysis revealed 4 variables with p < 0.25, gender (p = 0,056), ethnicity (p = 0, 231), surveillance education (p = 0,005), and severity of cirrhosis (p = 0, 005). Multivariate analysis showed that the risk factors for surveillance were surveillance education (OR = 2,598; CI 95% (1,325 - 5,094), p = 0,005) and severity of cirrhosis (OR = 1.815; CI 95% = 1,210-2,724; p = 0,004).

Conclusion: Surveillance education and severity of cirrhosis were the factors associated with surveillance for early detection of HCC in liver cirrhosis patients.


chirrosis of the liver; surveillance; related factors

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Lo CM, Ngan H, Tso WK, Liu CL, Lam CM, Poon RT, et al. Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma. Hepatology. 2002 May;35(5):1164-71.

Bruix J. Treatment of hepatocellular carcinoma. Hepatology. 1997;25(2):259-62.

Mulyana E. Analisis kesintasan pasien hepatoma di RSUPN-CM Jakarta. [Tesis]. Jakarta: Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia; 2001.

Loho IM, Hasan I, Lesmana CR, Dewiasty E, Gani RA. Hepatocellular carcinoma in tertiary referral hospital in indonesia: lack of improvement of one-year survival rates between 1998-1999 and 2013-2014. Asian Pasific Journal of Cancer Prevention.2016;17(4):2165-70.

Davila JA, Morgan RO, Richardson PA, Du XL, McGlynn KA, El-Serag HB. Use of surveillance for hepatocellular carsinoma among patients with cirrhosis in the united states. Hepatology. 2010;52:132-41.

Webb GJ, Wright KV, Harrod EC, Gorard DA, Coller JD, Evans AK. Surveillance for hepatocellular carcinoma in a mixed-aetiology UK cohort with cirrhosis:does a-protein still have a role. Clinical Medicine. 2015;15(2):139-44.

Kohli A, Murphy AA, Agarwai C, Shivakumar B, Kottill S, Polis MA. HCC surveillance results in earlier HCC detection: results from an indian cohort. Springer Plus. 2014;3:610-15.

Singal AG, Conjeevaram HS, Volk ML, Fu S, Fontana RJ, Askari F, et al. Effectiveness of hepatocellular carcinoma surveillance in patients with cirrhosis. Cancer Epidemiol Biomarkers Prev. 2012 May;21(5):793-9.

Marino L, Jornayvaz FR. Endocrine causes of nonalcoholic fatty liver disease. World Journal of Gastroenterology. 2015; 21(39):11053-76.

Guy J, Peters MG. Liver disease in women: The influence of gender on epidemiology, natural history, and patient outcomes. Gastroenterology & Hepatology. 2013;9(10). 633-39.

Schuppan D, Afdhal, NH. Liver cirrhosis. NIH Public Access. Lancet. 2008;371(9615):838-51.

Jin J, Sklar GE, Oh VM, Li SC. Factors affecting therapeutic compliance: a review from the patient's perspective. Therapeutics and Clinical Risk Management. 2008;4(1):269-86.

DOI: https://doi.org/10.24871/1832017153-158


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