Role of fibroscan in the management of patients with hepatocellular carcinoma / Mohamed Hosney Farouk Ali ; Supervised Ashraf Omar Abdelaziz , Aisha Mahmoud Elsharkawy , Mohamed Ibrahim Saif Elnasr

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Tropical Medicine

Background: Hepatocellular carcinoma (HCC) is a challenging malignancy of global importance it is associated with a high rate of mortality and its prevalence in the world is increasing. In the management of HCC, attention must be focused on the presence and degree of the underlying chronic liver disease at first observation, which will influence the choice of the treatment. Transient elastography (FibroScan®; Echosens SA, Paris, France) is a non-invasive method that uses measurements of liver stiffness (LS) to assess hepatic fibrosis in patients with chronic liver disease. Aim of work: evaluation of the role of fibroscan in deciding the treatment modality for patients with hepatocellular carcinoma. Results: - TACE was done in 74patients (72.5%) with median of liver stiffness (LS) 27.8Kpa.Patients who did MWA were 16 patients (15.7%) with median of LS 24 Kpa. Surgical resection was done to 5patients (4.7%) with median of LS 34.3Kpa and 7 patients (6.9%) received combined treatment with median of LS 34.8 Kpa. Significant relation between LS and both size of spleen (p-value=0.023) and severe portal hypertension (p-value=0.042). MELD score was the only independent factor that affect the choice of TACE [OR: 1.208 (95% CI: 0.998-1.462)]. MELD score and the size of the focal lesion were the only independent factors that affect the choice of microwave [OR: 0.750 (95% CI: 0.593-0.948) and 1.483 (95% CI: 1.015-2.167 respectively]. Concolusion : Liver stiffness by Fibroscan is important to assess liver condition in patients with HCC and to predict portal hypertension but may not help in deciding the treatment modality for HCC

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