Recent progress in the management of hepatocellular carcinoma detected during a surveillance program in Japan

• Published in: Hepatology research Vol. 40; no. 10; pp. 989 - 996
• Main Authors: Nakano, Masahito, Ando, Eiji, Kuromatsu, Ryoko, Torimura, Takuji, Sumie, Shuji, Takata, Akio, Fukushima, Nobuyoshi, Kurogi, Junichi, Niizeki, Takashi, Iwamoto, Hideki, Tanaka, Masatoshi, Sata, Michio
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01.10.2010
• Subjects: carcinoma; cirrhosis; hepatocellular surveillance; prognosis
• ISSN: 1386-6346; 1872-034X; 1872-034X
• DOI: 10.1111/j.1872-034X.2010.00706.x

Aim:  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]). Conclusion:  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.