title: Surveillance program for early detection of hepatocellular carcinoma in Japan: results of specialized department of liver disease.
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.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume city, Fukuoka, Japan. nyando@med.kurume-u.ac.jp
authors.forename: Eiji
authors.initials: E
authors.lastname: Ando
authors.forename: Ryoko
authors.initials: R
authors.lastname: Kuromatsu
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Tanaka
authors.forename: Akio
authors.initials: A
authors.lastname: Takada
authors.forename: Nobuyoshi
authors.initials: N
authors.lastname: Fukushima
authors.forename: Shuji
authors.initials: S
authors.lastname: Sumie
authors.forename: Sakae
authors.initials: S
authors.lastname: Nagaoka
authors.forename: Jyunji
authors.initials: J
authors.lastname: Akiyoshi
authors.forename: Kinya
authors.initials: K
authors.lastname: Inoue
authors.forename: Takuji
authors.initials: T
authors.lastname: Torimura
authors.forename: Ryukichi
authors.initials: R
authors.lastname: Kumashiro
authors.forename: Takato
authors.initials: T
authors.lastname: Ueno
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
mesh_terms: 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
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D012709:Serum Albumin; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin; D001663:Bilirubin