Regular surveillance by imaging for early detection and better prognosis of hepatocellular carcinoma in patients infected with hepatitis C virus.
OBJECTIVE
This study evaluated the usefulness of regular check-ups by ultrasonography and contrast-enhanced imaging for early detection of hepatocellular carcinoma (HCC) in a retrospective analysis.


METHODS
From April 2001 to March 2007, 240 consecutive patients with HCC who were infected with hepatitis C virus (HCV) were divided into three groups. Patients diagnosed with HCC by repeated imaging constituted Group A (surveillance group). Group B comprised patients in whom HCC was detected during scheduled doctor visits for liver disease or other diseases such as diabetes. Group C comprised non-screened patients.


RESULTS
The prevalence of solitary tumors decreased from Group A through Group B to Group C (66, 48 and 24%, respectively, P < 0.001). The proportion of patients in stages I and II decreased from 83% (103/124) in Group A to 53% (42/79) in Group B and 24% (9/37) in Group C (P < 0.001). The proportion of patients who were treated with curative procedures, such as resection or ablation, was highest at 80% (99/124) in Group A, and lower at 53% (42/79) in Group B and 27% (10/37) in Group C (P < 0.001). The cumulative survival rate was better in Group A than B (P < 0.05), and in Group B than C (P < 0.001). Periodical medical check-ups without imaging did not necessarily detect early-stage disease, even when HCC-related markers including des-gamma-carboxy prothrombin were tested.


CONCLUSIONS
Regular surveillance with ultrasonography and contrast-enhanced imaging is useful for detecting early-stage HCC and increase chances for curative treatments in patients with HCV-related chronic liver disease.
Noda
Ikue
I
Department of Gastroenterology, Hiroshima Prefectural Hospital, 1-5-54, Ujina-Kanda, Minami-ku, Hiroshim, 734-8530, Japan.
Kitamoto
Mikiya
M
Nakahara
Hideki
H
Hayashi
Ryohei
R
Okimoto
Tomoaki
T
Monzen
Yoshio
Y
Yamada
Hiroyasu
H
Imagawa
Masaru
M
Hiraga
Nobuhiko
N
Tanaka
Junko
J
Chayama
Kazuaki
K
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D003287:Contrast Media; D042241:Early Diagnosis; D005260:Female; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D003287:Contrast Media