title: Surveillance programme for hepatocellular carcinoma improves the survival of patients with chronic viral hepatitis.
abstract: BACKGROUND
  The survival benefit of surveillance for hepatocellular carcinoma (HCC) is controversial.
  
  
  OBJECTIVE
  We aimed to examine the survival benefit of HCC surveillance in chronic viral hepatitis.
  
  
  METHODS
  Survivals of HCC patients related to chronic viral hepatitis from the Hepatology Clinic (surveillance group) were compared with those referred from other hospitals/clinics (no-surveillance group). Lead-time and length-time biases were adjusted based on tumour volume doubling times.
  
  
  RESULTS
  Among 579 patients (91% hepatitis B), 472 (82%) patients had HCC and 79 (17%) of these patients were referred from the surveillance programme. HCC was smaller (4.2 vs. 7.7 cm; P<0.001) and fewer in numbers (2.6 vs. 3.8, P=0.03) in the surveillance group vs. the no-surveillance group. Treatment by surgery (20 vs. 10%, P=0.007) and local ablative therapy (46 vs. 19%, P<0.001) were more frequent in the surveillance group than that in the no-surveillance group. The median survival of the surveillance group (88 weeks) was significantly longer than that of the no-surveillance group (26 weeks) (P<0.001). The adjusted cumulative survival at 2 years was significantly longer in the surveillance group if the tumour volume doubling time was <90 days (P=0.0352).
  
  
  CONCLUSIONS
  HCC surveillance can improve the survival of patients with chronic viral hepatitis B.
authors: Institute of Digestive Disease and Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors: Grace Lai-Hung
authors: GL
authors: Wong
authors: Vincent Wai-Sun
authors: VW
authors: Wong
authors: Guang-Ming
authors: GM
authors: Tan
authors: Ka-Ian
authors: KI
authors: Ip
authors: Wing-Kwan
authors: WK
authors: Lai
authors: Yuk-Wah
authors: YW
authors: Li
authors: Mercedes Shun-Chi
authors: MS
authors: Mak
authors: Paul Bo-San
authors: PB
authors: Lai
authors: Joseph Jao-Yiu
authors: JJ
authors: Sung
authors: Henry Lik-Yuen
authors: HL
authors: Chan
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000517:prevention & control*; D005260:Female; D006525:Hepatitis, Viral, Human / Q000401:mortality* / Q000821:virology*; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016019:Survival Analysis; D013997:Time Factors