engleski

Treatment Outcomes of Hepatocellular Carcinoma Proven by Fine Needle Aspiration Cytology : A Single Center Experience

Hepatocellular carcinoma (HCC) mostly occurs in chronic liver disease and cirrhosis. Surgical resection and liver transplantation (LT) represent potentially curative treatments of choice and if not feasible, palliative strategies such as percutaneous interventional techniques (PITs) and systemic therapy (ST) are considered. Elevated alfafetoprotein, typical imaging pattern, needle core biopsy (NCB) and fine needle aspiration cytology (FNAC) complement diagnostic assessment of HCC. We have retrospectively analyzed HCC diagnosed by FNAC at our institution from 2004-2009 regarding treatment options. Ultrasound guided FNAC was performed in cases of contraindications for NCB. No complications were documented, except for mild transitory discomfort at the site of puncture. The diagnosis was verified by May-Grunwald- Giemsa (MGG) staining and immunohistochemistry. In overall of 62 patients, HCC developed in 61% and 39% in cirrhotic and non-cirrhotic liver, respectively. Underlying cause of liver disease was alcohol abuse in 32% and viral diseases in 13% of cases. In the setting of cirrhosis 16% of patients underwent PITs, 18% liver transplantation, 26% ST and 40% symptomatic therapy. In non-cirrhotic patients resection, ST, symptomatic therapy and PIT were applied in 46%, 25%, 25% and 4%, respectively. Pathohistology of resected and explanted livers (18 cases) confirmed the initial diagnosis. Our observations demonstrate that screening of high-risk groups and early identification of HCC should be addressed more intensely, since only early stage of HCC offers potentially curative treatment options. FNAC offers minimally invasive, rapid and uncomplicated diagnostic approach in the setting of abnormal coagulation and ascites commonly seen in advanced liver disease, providing therefore simple and effective diagnostic tool.

HCC; FNA

nije evidentirano