Surveillance program for early detection of hepatocellular carcinoma in Japan: results of specialized department of liver disease.
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.
Ando
Eiji
E
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume city, Fukuoka, Japan. nyando@med.kurume-u.ac.jp
Kuromatsu
Ryoko
R
Tanaka
Masatoshi
M
Takada
Akio
A
Fukushima
Nobuyoshi
N
Sumie
Shuji
S
Nagaoka
Sakae
S
Akiyoshi
Jyunji
J
Inoue
Kinya
K
Torimura
Takuji
T
Kumashiro
Ryukichi
R
Ueno
Takato
T
Sata
Michio
M
D000368:Aged; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D019698:Hepatitis C, Chronic / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D006748:Hospital Departments; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D008108:Liver Diseases, Alcoholic / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011159:Population Surveillance; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D012709:Serum Albumin / Q000378:metabolism; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D000509:alpha-Fetoproteins / Q000378:metabolism
D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D012709:Serum Albumin; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin; D001663:Bilirubin