Hepatocellular carcinoma — ESEGH MCQ

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HardGI CancerHepatocellular carcinomaESEGH

A patient with compensated cirrhosis remains eligible for hepatocellular-carcinoma treatment. The latest surveillance ultrasound is normal and AFP is not elevated. What follow-up is appropriate?

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Correct answer: C — Repeat liver ultrasound surveillance in 6 months

The best answer is “Repeat liver ultrasound surveillance in 6 months”. Adults with cirrhosis eligible for treatment undergo ultrasound-based HCC surveillance at six-month intervals; a normal AFP does not replace imaging surveillance. “Discharge from surveillance because AFP is normal” is less appropriate because AFP alone cannot exclude an early tumour. “Repeat ultrasound in 2 years” is less appropriate because that interval is too long for cirrhosis surveillance. “Arrange routine liver biopsy now” is less appropriate because a normal surveillance examination does not justify biopsy. “Use non-contrast CT every month” is less appropriate because this is neither the recommended modality nor interval.

Reference: EASL hepatocellular carcinoma guideline: https://easl.eu/publication/easl-clinical-practice-guidelines-management-of-hepatocellular-carcinoma/