Recent progress in the management of hepatocellular carcinoma detected during a surveillance program in Japan.
OBJECTIVE
This study explored recent improvements in the management of hepatocellular carcinoma (HCC) diagnosed during surveillance.


METHODS
The subjects were 1074 patients with HCC, subdivided into three groups. Group A comprised 211 patients for whom HCC was detected during periodic follow-up examinations at Kurume University School of Medicine, Group B comprised 544 patients diagnosed with HCC during periodic follow-up examinations at other institutions, and, Group C comprised 319 patients with HCC detected incidentally or because of symptoms.


RESULTS
In 1995-2000 and 2001-2006, 91% and 91% of group A, 68% and 70% of group B, and 27% and 26% of group C patients with HCC, respectively, met the Milan criteria. For groups A and B, the proportions of patients with Child-Pugh class A and use of promising treatment increased in the later periods compared to those diagnosed during the earlier periods (group A, Child-Pugh class A, 72% vs 58% [P = 0.040], receiving treatment, 90% vs 70% [P < 0.0001]; group B, Child-Pugh class A, 71% vs 62% [P = 0.031]; receiving treatment, 72% vs 52% [P < 0.0001], respectively). The cumulative survival rates of the 405 patients with HCC detected in the latter 6 years tended to be better than those for patients diagnosed in the former 6 years (350 patients) (4 years, 58% vs 50% [P = 0.0349]).


CONCLUSIONS
The use of promising treatment and prognosis have improved in the last 6 years for patients with HCC diagnosed through surveillance relative to those identified in 1995-2000.
Nakano
Masahito
M
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume Department of Internal Medicine, Inoue Hospital, Maebaru Department of Internal Medicine, Kurume University Medical Center, Kurume, Fukuoka, Japan.
Ando
Eiji
E
Kuromatsu
Ryoko
R
Torimura
Takuji
T
Sumie
Shuji
S
Takata
Akio
A
Fukushima
Nobuyoshi
N
Kurogi
Junichi
J
Niizeki
Takashi
T
Iwamoto
Hideki
H
Tanaka
Masatoshi
M
Sata
Michio
M