The impact of newer treatment modalities on survival in patients with hepatocellular carcinoma.
OBJECTIVE
Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide. However, although the therapeutic approaches for HCC have progressed rapidly, it remains unknown whether the current management of patients with HCC has reduced its mortality. We analyzed changes of survival rate in patients with HCC over a 20-year period.


METHODS
Between 1982 and 2001, 463 patients were diagnosed with HCC at our hospital. Subjects were enrolled in the current cohort according to the following inclusion criteria: HCC lesion measuring less than 3 cm in diameter, no evidence of extrahepatic metastasis, and no evidence of main portal vein infiltration/thrombosis. A total of 257 patients with HCC were recruited for this study, and categorized into 5-year intervals.


RESULTS
The survival rates improved significantly during the study period. When the patients were stratified according to Child-Pugh score, only patients with Child's B showed improved survival rates. Furthermore, patients with surgical resection or transarterial chemoembolization during the latter period had a better prognosis than those during the early period.


CONCLUSIONS
Our findings suggest that the development of therapeutic interventions for HCC have led to improvements in the prognosis for HCC patients.
Taura
Naota
N
First Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto, Nagasaki, Japan. ntaura-gi@umin.ac.jp
Hamasaki
Keisuke
K
Nakao
Kazuhiko
K
Ichikawa
Tatsuki
T
Nishimura
Daisuke
D
Goto
Takashi
T
Fukuta
Mariko
M
Kawashimo
Hiroshi
H
Fujimoto
Masumi
M
Kusumoto
Koichiro
K
Motoyoshi
Yasuhide
Y
Shibata
Hidetaka
H
Eguchi
Katsumi
K
D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic; D015331:Cohort Studies; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012997:Solvents / Q000627:therapeutic use; D015996:Survival Rate
D000970:Antineoplastic Agents; D012997:Solvents; D000431:Ethanol