Does transient elastography (FibroScan®) have a role in decision making in hepatocellular carcinoma?

• Published in: HPB (Oxford, England) England), 2012-06, Vol.14 (6), p.403-408
• Main Authors: Pesce, Antonio, Scilletta, Roberto, Branca, Angela, Nigro, Luciano, Montineri, Arturo, Larocca, Licia, Fatuzzo, Filippo, Castaing, Marine, Puleo, Stefano
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Algorithms; Barcelona Clinic Liver Cancer (BCLC); Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - therapy; Carcinoma, Hepatocellular - virology; Chi-Square Distribution; Decision Support Techniques; Elasticity Imaging Techniques; Esophageal and Gastric Varices - pathology; Esophageal and Gastric Varices - virology; Esophagoscopy; Female; Gastroenterology and Hepatology; Hepatitis C - complications; hepatocellular carcinoma; Humans; Hypertension, Portal - diagnostic imaging; Hypertension, Portal - pathology; Hypertension, Portal - therapy; Hypertension, Portal - virology; Italy; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - pathology; Liver Cirrhosis - therapy; Liver Cirrhosis - virology; liver fibrosis; Liver Function Tests; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - pathology; Liver Neoplasms - therapy; Liver Neoplasms - virology; liver stiffness; Male; Middle Aged; Original; Patient Selection; Platelet Count; portal hypertension; Predictive Value of Tests; Risk Assessment; Risk Factors; Splenomegaly - pathology; Splenomegaly - virology; transient elastography
• ISSN: 1365-182X; 1477-2574
• DOI: 10.1111/j.1477-2574.2012.00465.x

Abstract Objectives Portal hypertension has been reported as a negative prognostic factor and a relative contraindication for liver resection. This study considers a possible role of fibrosis evaluation by transient elastography (FibroScan®) and its correlation with portal hypertension in patients with cirrhosis, and discusses the use of this technique in planning therapeutic options in patients with hepatocellular carcinoma (HCC). Methods A total of 77 patients with cirrhosis, 42 (54.5%) of whom had HCC, were enrolled in this study during 2009–2011. The group included 46 (59.7%) men. The mean age of the sample was 65.2 years. The principle aetiology of disease was hepatitis C virus (HCV)-related cirrhosis (66.2%). Liver function was assessed according to Child–Pugh classification. In all patients liver stiffness (LS) was measured using FibroScan®. The presence of portal hypertension was indirectly defined as: (i) oesophageal varices detectable on endoscopy; (ii) splenomegaly (increased diameter of the spleen to ≥12 cm), or (iii) a platelet count of