[Surveillance for hepatocellular carcinoma: does it work?].
BACKGROUND
The surveillance of cirrhotic patients for early detection of hepatocellular carcinoma is recommended but its efficacy is now discussed. The aim of our study was to present the results of a screening program in 110 patients.


METHODS
it is a retrospective study that included 110 patients with cirrhosis in a screening program of hepatocellular carcinoma, based on the realization of abdominal ultrasound exam and the determination of alpha-fetoprotein amount every 6 months in 95 patients and every 3 months in 15 patients.


RESULTS
the mean duration of the surveillance was 36 months. A hepatocellular carcinoma was diagnosed in 13 patients. Curative treatment was done in only 3 cases and consisted in a hepatic resection in 1 patient and an alcoolisation in 2 cases. Ten patients had new treatment : for 8 patients the discussed was very agressive and 2 patients had a server hepotic failure. The cost of this study was 37.500 Tunisian dinars.


CONCLUSIONS
systematic screening for hepatocellular carcinoma offer a limited cost effectiveness ratio.
Kchaou-Ouakaa
Asma
A
Service de gastro-entérologie de l'hôpital Habib Thameur, Tunis, Tunisie.
Belhadjbrik
Najet
N
Elloumi
Hela
H
Gargouri
Dalila
D
Kochlef
Asma
A
Kilani
Afef
A
Romani
Malika
M
Kharrat
Jamel
J
Ghorbel
Abdeljabbar
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging; D042241:Early Diagnosis; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging; D017093:Liver Failure / Q000209:etiology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011159:Population Surveillance; D011446:Prospective Studies; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000032:analysis
D000509:alpha-Fetoproteins