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Surveillance programme for hepatocellular carcinoma improves the survival of patients with chronic viral hepatitis
Author(s) -
Wong Grace LaiHung,
Wong Vincent WaiSun,
Tan GuangMing,
Ip KaIan,
Lai WingKwan,
Li YukWah,
Mak Mercedes ShunChi,
Lai Paul BoSan,
Sung Joseph JaoYiu,
Chan Henry LikYuen
Publication year - 2008
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.1478-3231.2007.01576.x
Subject(s) - medicine , hepatocellular carcinoma , hepatology , viral hepatitis , gastroenterology , chronic hepatitis , hepatitis b , immunology , virus
Background: The survival benefit of surveillance for hepatocellular carcinoma (HCC) is controversial. Aim: We aimed to examine the survival benefit of HCC surveillance in chronic viral hepatitis. Methods: Survivals of HCC patients related to chronic viral hepatitis from the Hepatology Clinic (surveillance group) were compared with those referred from other hospitals/clinics (no‐surveillance group). Lead‐time and length‐time biases were adjusted based on tumour volume doubling times. Results: Among 579 patients (91% hepatitis B), 472 (82%) patients had HCC and 79 (17%) of these patients were referred from the surveillance programme. HCC was smaller (4.2 vs. 7.7 cm; P <0.001) and fewer in numbers (2.6 vs. 3.8, P =0.03) in the surveillance group vs. the no‐surveillance group. Treatment by surgery (20 vs. 10%, P =0.007) and local ablative therapy (46 vs. 19%, P <0.001) were more frequent in the surveillance group than that in the no‐surveillance group. The median survival of the surveillance group (88 weeks) was significantly longer than that of the no‐surveillance group (26 weeks) ( P <0.001). The adjusted cumulative survival at 2 years was significantly longer in the surveillance group if the tumour volume doubling time was <90 days ( P =0.0352). Conclusions: HCC surveillance can improve the survival of patients with chronic viral hepatitis B.