Surveillance of primary sclerosing cholangitis – a comparison of scheduled or on-demand ERCP with annual MRI surveillance: a multicenter study
Rattachement africain : fi, se, nl. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Background: Primary sclerosing cholangitis (PSC) is associated with a high risk of hepatobiliary malignancy, especially cholangiocarcinoma (CCA). There are no good tumor markers to screen for CCA, and current recommendations for PSC monitoring are mainly based on expert opinions. The optimal strategy to assess disease progression and screen for CCA – the main cause of death of PSC patients – remains unclear. We aimed to compare three different surveillance strategies and their effect on patient outcomes. Methods: Data from three distinct PSC cohorts with different surveillance strategies – scheduled endoscopic retrograde cholangiopancreatography (ERCP), annual magnetic resonance imaging/cholangiopancreatography (MRI/MRCP) surveillance, and on-demand ERCP according to ESGE/EASL guidelines – was collected. Patients with PSC diagnosed in 1990 or later were included and the last day of follow-up was 31 December 2023. The composite end point consisted of hepatobiliary malignancy, liver transplantation, or liver-related death. Results: 1629 PSC patients were included, with a median follow-up of 8–11 years. The cumulative incidence of the composite end point was lowest in the group undergoing scheduled ERCP (14.1%, 95%CI 12.0%–16.4%) and highest in the on-demand ERCP cohort (35.0%, 95%CI 28.4%–42.0%). Although the cumulative incidence of CCA was lower in the scheduled ERCP group than in the other groups, it did not differ statistically significantly from the MRI/MRCP surveillance group. No differences were seen in liver-related deaths between the surveillance strategies. Conclusions: In this study comparing scheduled ERCP, annual MRI/MRCP surveillance, and on-demand ERCP, the strategy based on scheduled ERCP using individual risk stratification is associated with better overall prognosis and outcome.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Surveillance of primary sclerosing cholangitis – a comparison of scheduled or on-demand ERCP with annual MRI surveillance: a multicenter study
- Date Crossref
- 28/01/2025
- Éditeur
- Georg Thieme Verlag KG
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Helsinki University Hospital pays non établi dans la noticeÉtablissement de santé
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University of Gothenburg Department of Molecular and Clinical Medicine pays non établi dans la noticeUniversité ou école supérieure
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Amsterdam University Medical Centers pays non établi dans la noticeÉtablissement de santé
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Karolinska University Hospital Department of Gastroenterology and Hepatology pays non établi dans la noticeÉtablissement de santé
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University of Eastern Finland Institute of Public Health and Clinical Nutrition pays non établi dans la noticeUniversité ou école supérieure
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Folkhälsans Forskningscentrum pays non établi dans la noticeOrganisme public
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Helsinki University Central Hospital Department of Gastroenterology pays non établi dans la noticeUniversité ou école supérieure
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Department of Gastroenterology and Hepatology pays non établi dans la noticeInstitution
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Folkhalsan Research Centre Primary Health Care pays non établi dans la noticeStructure de recherche
Helsinki University Hospital, Department of Molecular and Clinical Medicine — University of Gothenburg et Amsterdam University Medical Centers, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.