Hepatocellular Carcinoma Follow Up

Surveillance

Multiphasic cross-sectional imaging (eg computed tomography or abdominal magnetic resonance imaging for liver assessment, chest computed tomography and computed tomography/magnetic resonance imaging of the pelvis) is the preferred method for surveillance following treatment due to its reliability in assessing arterial vascularity that is associated with increased risk of hepatocellular carcinoma recurrence following treatment. The test should be done every 3-6 months for 2 years, then every 6 months for at least 5 years after which testing is dependent on hepatocellular carcinoma risk factors. Serum alpha fetoprotein levels are associated with poor prognosis following treatment and should be measured every 3-6 months for 2 years, then every 6 months or at least 5 years after which testing is dependent on hepatocellular carcinoma risk factors. In the event of disease recurrence, re-evaluation according to the initial work-up should be considered. Referral to a hepatologist should be considered to discuss antiviral therapy for hepatitis carriers, if not previously done.