title: Hepatocellular carcinoma surveillance at 4- vs. 12-month intervals for patients with chronic viral hepatitis: a randomized study in community.
abstract: OBJECTIVE
  To compare the efficacy of hepatocellular carcinoma (HCC) surveillance at 4- and 12-month intervals in a community for patients with chronic viral hepatitis and thrombocytopenia.
  
  
  METHODS
  In 10 townships, adults (≥ 40 years) with platelet ≤ 150 (× 10(9))/l, positive hepatitis B surface antigen, or antibody to hepatitis C virus were invited to this study. These townships were randomized into 4- (group A) and 12-month (group B) interval surveillance groups. Seven hundred and eighty-five and 796 residents met the study criteria in groups A and B. Ultrasonography (US) was the surveillance method.
  
  
  RESULTS
  A total of 744 residents (group A: 387; group B: 357) were enrolled. In the study period, HCC was diagnosed in 39 residents (group A: 24; group B: 15). There was no difference in cumulative 3-year HCC incidence between the two groups. The tumors were smaller in group A than in group B, though group A had more patients with tumor ≤ 2 cm (P = 0.003) who were in Barcelona Clinic Liver Cancer (BCLC) very-early stage (P = 0.017) and had undergone curative treatments (P = 0.049). Male gender, cirrhosis, and platelet ≤ 100 (× 10(9))/l were associated factors of HCC occurrence. There was no difference in 4-year overall survival between the two groups. Patients undergoing recommended treatments had better 4-year survival rates.
  
  
  CONCLUSIONS
  Compared with 12-month interval, US surveillance at 4-month interval detected more patients with HCC ≤ 2 cm who were in BCLC very-early stage and were fit for curative treatments. Up to 4-year follow-up, however, the overall survival was not different.
authors: Department of Internal Medicine, Division of Hepatogastroenterology, Kaohsiung Chang Gung Memorial Hospital, NiaoSong, Kaohsiung, Taiwan.
authors: Jing-Houng
authors: JH
authors: Wang
authors: Kuo-Chin
authors: KC
authors: Chang
authors: Kwong-Ming
authors: KM
authors: Kee
authors: Pao-Fei
authors: PF
authors: Chen
authors: Yi-Hao
authors: YH
authors: Yen
authors: Po-Lin
authors: PL
authors: Tseng
authors: Yuan-Hung
authors: YH
authors: Kuo
authors: Ming-Chao
authors: MC
authors: Tsai
authors: Chao-Hung
authors: CH
authors: Hung
authors: Chien-Hung
authors: CH
authors: Chen
authors: Wei-Chen
authors: WC
authors: Tai
authors: Lin-San
authors: LS
authors: Tsai
authors: Shu-Chuan
authors: SC
authors: Chen
authors: Sheng-Che
authors: SC
authors: Lin
authors: Sheng-Nan
authors: SN
authors: Lu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate