{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T07:10:26Z","timestamp":1765609826412,"version":"3.37.3"},"reference-count":27,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2018,3,22]],"date-time":"2018-03-22T00:00:00Z","timestamp":1521676800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2018,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Surveillance for hepatocellular carcinoma (HCC) intends to detect tumors at an early stage to improve survival. The study aims were to assess the frequency and risk factors associated with HCC surveillance failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study analyzed data from 188 consecutive patients diagnosed with HCC within a surveillance program conducted among 1,242 cirrhotic patients and based on ultrasonography and alpha\u2010fetoprotein (AFP) testing every 3 or 6\u00a0months. Program failure was defined as the detection of HCC exceeding the Milan criteria. Variables recorded at entry into the program, during follow\u2010up and at HCC diagnosis, were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At diagnosis, 50 (26.6%) HCC tumors were beyond the Milan criteria. In univariate analysis, Child\u2010Pugh B at entry (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.03), development of complications of portal hypertension before tumor diagnosis (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.03), and failure to complete the prior screening round (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02), Child\u2010Pugh B\/C (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001) and AFP\u00a0\u2265\u00a0100\u00a0ng\/mL (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.03) at diagnosis, were associated with failure. In multivariate analysis, only Child\u2010Pugh B\/C (hazard ratio, 3.18; 95% confidence interval, 1.66\u20136.10, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and AFP\u00a0\u2265\u00a0100\u00a0ng\/mL, both at diagnosis (hazard ratio, 2.80; 95% confidence interval, 1.37\u20135.71, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.005), were independently associated with failure. Survival was higher among patients with tumors within the Milan criteria than those with program failure (33.9 <jats:italic>vs<\/jats:italic> 7.6\u00a0months, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Approximately 25% of HCC cases diagnosed among patients included in a surveillance program were beyond the Milan criteria. Child\u2010Pugh B\/C and AFP\u00a0\u2265\u00a0100\u00a0ng\/mL at diagnosis were associated with program failure. However, Child\u2010Pugh B at entry and development of liver\u2010related complications during follow\u2010up can be early predictors of failure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14108","type":"journal-article","created":{"date-parts":[[2018,1,31]],"date-time":"2018-01-31T17:41:53Z","timestamp":1517420513000},"page":"1524-1529","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Incidence and risk factors associated with hepatocellular carcinoma surveillance failure"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9046-0144","authenticated-orcid":false,"given":"Alejo","family":"Mancebo","sequence":"first","affiliation":[{"name":"Liver Unit, Department of Gastroenterology and Hepatology Hospital Universitario Central de Asturias, University of Oviedo  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Varela","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Gastroenterology and Hepatology Hospital Universitario Central de Asturias, University of Oviedo  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Luisa","family":"Gonz\u00e1lez\u2010Di\u00e9guez","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Gastroenterology and Hepatology Hospital Universitario Central de Asturias, University of Oviedo  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen A","family":"Navascu\u00e9s","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Gastroenterology and Hepatology Hospital Universitario Central de Asturias, University of Oviedo  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valle","family":"Cadah\u00eda","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Gastroenterology and Hepatology Hospital Universitario Central de Asturias, University of Oviedo  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alicia","family":"Mesa\u2010\u00c1lvarez","sequence":"additional","affiliation":[{"name":"Department of Radiology Hospital Universitario Central de Asturias  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis","family":"Rodrigo","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Gastroenterology and Hepatology Hospital Universitario Central de Asturias, University of Oviedo  Oviedo Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuel","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Liver Unit, Department of Gastroenterology and 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