Characteristics and Survival Outcomes of Hepatocellular Carcinoma After the Fontan Operation
Authors' conclusion
We describe the clinical characteristics, treatment, and survival in patients with FALD-HCC. Results suggest that adults with FALD-HCC diagnosed with early stage disease may have survival benefit. Our findings underscore the importance of HCC screening for early detection in individuals after the Fontan operation.
Study context
- Population
- Adults with Fontan circulation between 2005 and 2021; Hepatocellular carcinoma (HCC) cases included based on histology or imaging-based diagnosiscases of HCC
- Participants
- 58 adults
- Comparison
- HCC cases compared to controls
- Casesn = 58
- Outcome
- Age at HCC diagnosis
Methodological detailscontrols randomly selected in a 3:1 ratio from the center in which the case was derived
- Controls randomly selected in a 3:1 ratio from the center in which the case was derived
Main finding
As reported in the abstract
Cases
31
median · IQR 26–38 · years
Observational data: associations, not effects.
Further findings
Stage at diagnosis
- Diagnosed at very early or early stage disease
- 68%
Advanced Fontan-associated liver disease (FALD) (varices, ascites, splenomegaly, decreased platelets)
- Higher prevalence in cases compared to controls
Treatment with curative intent (combined heart-liver transplantation, resection, or ablation)
- Performed
- 41%
Survival · 1 year
- Survival at 1 year
- 78.9%
- Highest among those diagnosed at very early or early stage
Survival by active surveillance at diagnosis
- Over half undergoing active surveillance at diagnosis; nonsignificant trend toward higher survival
- P = 0.088
Original publication
Summarised from the published abstract; every number is checked against it