[Practical screening and early treatment of hepatocellular carcinoma. Results of a French survey].
OBJECTIVE
To describe French practices for screening hepatocellular carcinoma.


METHODS
A standardized questionnaire was mailed to all French hospital hepato-gastroenterologists in June 1999.


RESULTS
411 out of 623 practitioners responded (66%). 394 (96%) routinely screen hepatocellular carcinoma, mainly with ultrasound (98%) and mainly at 6-month intervals (77%). Screening was performed in cirrhosis (100%) or extensive fibrosis (54%), independent of the etiology (21%) or the Child-Pugh score of the chronic liver disease (41%), but based on age and treatment feasibility. If of a small hypoechogenic nodule was detected in a young patient with compensated HCV-cirrhosis, 59% of practitioners performed a histological examination. In case of non biopsy-proven hepatocellular carcinoma, a second biopsy (49%), treatment (either percutaneous alcohol injection, resection or transplantation) (24%) or an ultrasonographic follow-up (23%) was proposed. In case of biopsy-proven hepatocellular carcinoma, resection (49%), transplantation (30%) or percutaneous alcohol injection (16%) was proposed.


CONCLUSIONS
Almost all French specialists routinely screen cirrhotic patients for hepatocellular carcinoma, but use somewhat different modalities. In case of small HCC without contraindications to curative treatment, surgical resection is performed in half the patients.
Service d'Hépato-Gastroentérologie, Hôpital Jean Verdier (AP-HP, Université Paris 13), Bondy 93140, France. nathalie.ganne@jvr.ap-hop-paris.fr
Nathalie
N
Ganne-Carrié
Sylvie
S
Chevret
Jean-Claude
JC
Barbare
Cendrine
C
Chaffaud
Véronique
V
Grando
Anne-Marie
AM
Vogt
Michel
M
Beaugrand
Jean-Claude
JC
Trinchet
D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D000431:Ethanol / Q000008:administration & dosage; D005602:France; D006432:Hemochromatosis / Q000235:genetics; D006509:Hepatitis B; D006526:Hepatitis C; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications / Q000821:virology; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation; D010820:Physicians; D011795:Surveys and Questionnaires; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins; D000431:Ethanol