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Conference Paper: Evidence-based surveillance imaging schedule after liver transplantation for hepatocellular carcinoma recurrence
Title | Evidence-based surveillance imaging schedule after liver transplantation for hepatocellular carcinoma recurrence |
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Authors | |
Issue Date | 2016 |
Citation | Tthe 102nd Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA), Chicago, IL, USA, 27 November – 2 December 2016 How to Cite? |
Abstract | PURPOSE: here is presently no evidence-based recommendation for surveillance of recurrent hepatocellular carcinoma (HCC) after liver transplantation (LT). We aim to evaluate and develop evidence-based alternate surveillance imaging schedules for post LT HCC patients.
METHOD AND MATERIALS: Imaging and pathologic reports for consecutive post-LT patients followed-up by regular surveillance imaging from a single institution's prospective database were evaluated with institutional review board approval. Outcome variable was time to diagnosis of first recurrence post-LT by surveillance imaging. Recurrence-free survival times (RFST) from alternative surveillance schedules were compared with the existing schedule (3-monthly) using a parametric frailty model. Expected delay (EpD) in diagnosis compared to the existing schedule was also computed for the alternate surveillance schedules. A p value of less than 0.05 was considered to indicate a significant difference.
RESULTS: One hundred twenty five patients (108 men; 59.4 years ±16.6) underwent 1953 CT and 255 MRI scans. RFST was not significantly different in the first five years after LT when the imaging interval was extended from current 3-monthly to 6-monthly (p=0.786, EpD= 55 days). This alternative schedule incurred ten (50.0%) fewer surveillance scans than the 20 in the original schedule, and a corresponding reduction in radiation dose (if involved) and cost during the 5-year follow-up period.
CONCLUSION: In conclusion, modeled alternative surveillance schedules have the potential to reduce the frequency of scans without compromising surveillance benefits.
CLINICAL RELEVANCE/APPLICATION: Extending imaging surveillance schedules to 6-monthly from 3-monthly offers reduced frequency of scans without compromising surveillance benefits in post-transplant hepatocellular carcinoma patients.
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Description | Health Service, Policy and Research Wednesday Poster Discussions - paper no. HP228-SD-WEA3 |
Persistent Identifier | http://hdl.handle.net/10722/245520 |
DC Field | Value | Language |
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dc.contributor.author | Liu, D | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Fong, DYT | - |
dc.contributor.author | Lo, CM | - |
dc.contributor.author | Khong, PL | - |
dc.date.accessioned | 2017-09-18T02:12:09Z | - |
dc.date.available | 2017-09-18T02:12:09Z | - |
dc.date.issued | 2016 | - |
dc.identifier.citation | Tthe 102nd Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA), Chicago, IL, USA, 27 November – 2 December 2016 | - |
dc.identifier.uri | http://hdl.handle.net/10722/245520 | - |
dc.description | Health Service, Policy and Research Wednesday Poster Discussions - paper no. HP228-SD-WEA3 | - |
dc.description.abstract | PURPOSE: here is presently no evidence-based recommendation for surveillance of recurrent hepatocellular carcinoma (HCC) after liver transplantation (LT). We aim to evaluate and develop evidence-based alternate surveillance imaging schedules for post LT HCC patients. METHOD AND MATERIALS: Imaging and pathologic reports for consecutive post-LT patients followed-up by regular surveillance imaging from a single institution's prospective database were evaluated with institutional review board approval. Outcome variable was time to diagnosis of first recurrence post-LT by surveillance imaging. Recurrence-free survival times (RFST) from alternative surveillance schedules were compared with the existing schedule (3-monthly) using a parametric frailty model. Expected delay (EpD) in diagnosis compared to the existing schedule was also computed for the alternate surveillance schedules. A p value of less than 0.05 was considered to indicate a significant difference. RESULTS: One hundred twenty five patients (108 men; 59.4 years ±16.6) underwent 1953 CT and 255 MRI scans. RFST was not significantly different in the first five years after LT when the imaging interval was extended from current 3-monthly to 6-monthly (p=0.786, EpD= 55 days). This alternative schedule incurred ten (50.0%) fewer surveillance scans than the 20 in the original schedule, and a corresponding reduction in radiation dose (if involved) and cost during the 5-year follow-up period. CONCLUSION: In conclusion, modeled alternative surveillance schedules have the potential to reduce the frequency of scans without compromising surveillance benefits. CLINICAL RELEVANCE/APPLICATION: Extending imaging surveillance schedules to 6-monthly from 3-monthly offers reduced frequency of scans without compromising surveillance benefits in post-transplant hepatocellular carcinoma patients. | - |
dc.language | eng | - |
dc.relation.ispartof | Radiological Society of North America (RSNA) 102th Scientific Assembly and Annual Meeting | - |
dc.title | Evidence-based surveillance imaging schedule after liver transplantation for hepatocellular carcinoma recurrence | - |
dc.type | Conference_Paper | - |
dc.identifier.email | Chan, ACY: acchan@hku.hk | - |
dc.identifier.email | Fong, DYT: dytfong@hku.hk | - |
dc.identifier.email | Lo, CM: chungmlo@hkucc.hku.hk | - |
dc.identifier.email | Khong, PL: plkhong@hku.hk | - |
dc.identifier.authority | Chan, ACY=rp00310 | - |
dc.identifier.authority | Fong, DYT=rp00253 | - |
dc.identifier.authority | Lo, CM=rp00412 | - |
dc.identifier.authority | Khong, PL=rp00467 | - |
dc.identifier.hkuros | 278890 | - |