Surveillance programme for hepatocellular carcinoma improves the survival of patients with chronic viral hepatitis.
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.
Wong
Grace Lai-Hung
GL
Institute of Digestive Disease and Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
Wong
Vincent Wai-Sun
VW
Tan
Guang-Ming
GM
Ip
Ka-Ian
KI
Lai
Wing-Kwan
WK
Li
Yuk-Wah
YW
Mak
Mercedes Shun-Chi
MS
Lai
Paul Bo-San
PB
Sung
Joseph Jao-Yiu
JJ
Chan
Henry Lik-Yuen
HL
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