Clinical

Preoperative needle test does not adversely affect liver cancer outcomes

Last Updated: 2004-03-01 11:11:21 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Despite concerns about intraperitoneal seeding of tumors, preoperative fine-needle aspiration cytologic examination (FNAC) of liver nodules does not adversely affect long-term clinical outcomes in patients with hepatocellular carcinoma (HCC) after curative surgery, according to a report in the Archives of Surgery for February.

FNAC is a potentially useful test in working up liver nodules seen on imaging studies, senior author Dr. Sheung-Tat Fan, from Queen Mary Hospital in Hong Kong, and colleagues note. However, there have been reports that tumor seeding may occur along the needle tract, which could worsen the patient's prognosis.

To investigate, the researchers assessed the outcomes of 828 patients who underwent surgery for suspected HCC. Of these patients, 91 had undergone preoperative FNAC and 737 did not.

The resectability rates in both groups were nearly the same -- about 81%. No needle tract seeding was observed in any of the patients in the FNAC group, the researchers report.

Moreover, the rate of extrahepatic tumor spread in the FNAC group was 2%, lower but not significantly different from the 6% rate seen in the non-FNAC group. Also, long-term overall and disease-free survival rates were comparable for the two groups.

"To our knowledge, this is the first study of the impact of preoperative FNAC on long-term clinical outcome in patients with HCC," the investigators note. The results suggest that FNAC does not worsen resectability, raise the risk of extrahepatic tumor spread, or decrease long-term survival, they conclude.

Arch Surg 2004;139:193-200.