Surveillance program for early detection of hepatocellular carcinoma in Japan: results of specialized department of liver disease

J Clin Gastroenterol. 2006 Nov-Dec;40(10):942-8. doi: 10.1097/01.mcg.0000225675.14594.d6.

Abstract

Objective: Surveillance of cirrhotic patients enables early detection of hepatocellular carcinoma (HCC) and possibly prolongs survival. The aim of this study was to explore whether early-stage HCC can be detected earlier at a specialized department of liver disease than in other institutions.

Methods: The study subjects were 574 patients with HCC. Patients were subdivided into 3 groups according to the manner of HCC detection: group A, HCC was detected in 91 patients during periodic examination at Kurume University School of Medicine; group B, HCC was detected in 301 patients during periodic examination at other institutions; group C, HCC was detected incidentally or because of symptoms in 182 patients.

Results: The HCC detected in group A was significantly of smaller size (20.4 mm) compared with groups B (27.1 mm, P<0.0001) and C (57.8 mm, P<0.0001). The frequency of receiving treatment (surgery or local ablation therapy) was significantly higher in group A (73%) than in groups B (52%, P=0.002) and C (26%, P<0.0001). The 5-year survival rates were 52% for group A, 40% for group B, and 23% for group C, respectively. The survival of group A was significantly better than that of groups B (P=0.0157) and C (P<0.0001).

Conclusions: Surveillance for HCC at specialized Department of Liver Disease can detect early-stage HCC, resulting in a higher chance of receiving promising treatment.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Aged
  • Bilirubin / blood
  • Biomarkers / blood
  • Biomarkers, Tumor / blood
  • Carcinoma, Hepatocellular / diagnosis*
  • Carcinoma, Hepatocellular / etiology
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / therapy
  • Early Diagnosis
  • Female
  • Follow-Up Studies
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / epidemiology
  • Hepatitis B, Chronic / therapy
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / epidemiology
  • Hepatitis C, Chronic / therapy
  • Hospital Departments*
  • Humans
  • Japan / epidemiology
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / therapy
  • Liver Diseases, Alcoholic / complications
  • Liver Diseases, Alcoholic / epidemiology
  • Liver Diseases, Alcoholic / therapy
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / etiology
  • Liver Neoplasms / mortality
  • Liver Neoplasms / therapy
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Population Surveillance*
  • Protein Precursors / blood
  • Prothrombin
  • Serum Albumin / metabolism
  • Survival Rate
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Ultrasonography, Interventional
  • alpha-Fetoproteins / metabolism

Substances

  • Biomarkers
  • Biomarkers, Tumor
  • Protein Precursors
  • Serum Albumin
  • alpha-Fetoproteins
  • acarboxyprothrombin
  • Prothrombin
  • Bilirubin