Should Surveillance for Liver Cancer be Modified in Hepatitis C Patients After Treatment-related Cirrhosis Regression?

Roberta D'Ambrosio; Massimo Colombo


Liver International. 2016;36(6):783-790. 

In This Article

Current Recommendations in SVR Patients

European Association for the Study of the Liver (EASL) guidelines recommend semiannual surveillance with abdominal ultrasound (US) in patients with advanced liver fibrosis or cirrhosis who achieve an SVR following anti-HCV therapies. Surveillance is also advocated in SVR patients with any histological stage of hepatitis C who carry such comorbidities as alcohol abuse and diabetes, which are well-recognized independent risk factors for HCC disease progression, including HCC.[24,26,28,33,34] Owing to the fact that portal hypertension is the strongest predictor of liver cancer in patients with cirrhosis of any aetiology, whereas interferon therapy was often prevented in clinically decompensated patients, there is little ground to understand whether HCC is prevented by antiviral therapy in this fragile population. In the near future, the many patients with decompensated HCV who have been prioritized to DAAs therapy against HCV will help understanding whether clinically decompensated patients who achieve an SVR are protected against Hepatocellular carcinoma (HCC) risk too.