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Surveillance of hepatocellular carcinoma in patients with hepatitis C virus infection may improve patient survival
Author(s) -
Tanaka Hironori,
Nouso Kazuhiro,
Kobashi Haruhiko,
Kobayashi Yoshiyuki,
Nakamura Shinichiro,
Miyake Yasuhiro,
Ohnishi Hideki,
Miyoshi Kenji,
Iwado Shouta,
Iwasaki Yoshiaki,
Sakaguchi Kohsaku,
Shiratori Yasushi
Publication year - 2006
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2006.01270.x
Subject(s) - medicine , hepatocellular carcinoma , incidence (geometry) , gastroenterology , hepatitis c virus , cumulative incidence , hepatitis a virus , hepatitis b , hepatitis c , stage (stratigraphy) , virus , immunology , cohort , paleontology , physics , optics , biology
Background: The benefit of surveillance of hepatocellular carcinoma (HCC) for patients with hepatitis C virus (HCV) infection, in terms of long‐term survival, has not yet been established. Methods: A total of 384 consecutive anti‐HCV‐positive HCC patients admitted to our hospital between January 1991 and October 2003 were enrolled. Patients were categorized into two groups, a surveillance group (182 patients) and a non‐surveillance group (202 patients), according to tumor detection in a surveillance program based on periodical examination via ultrasound sonography and alpha fetoprotein determination at 6‐month intervals, and their survival rates were compared. Results: Although there were no significant differences in age and Child–Pugh classes between the two groups, the surveillance group exhibited a smaller tumor size (19 vs. 35 mm) and a higher incidence of single HCC (67% vs. 46%), compared with the non‐surveillance group (each, P <0.001). The cumulative survival rate in the surveillance group was higher than that in the non‐surveillance group (5 years survival, 46% vs. 32%, P <0.001). When the survival after correction of the lead‐time bias in the surveillance group was analyzed according to the Child–Pugh classification, the surveillance program was found to have had a favorable outcome in Child–Pugh class A patients, but not in Child–Pugh class B/C patients. Conclusions: HCC surveillance for patients with HCV infection can lead to discovery of tumors at an early stage, especially in Child–Pugh class A, resulting in a favorable outcome.