Historically, only 10% of hepatocellular cancer (HCC) patients are diagnosed with early stage, potentially curable disease. We prospectively screened chronic hepatitis virus-infected patients to determine 1) the proportion diagnosed with potentially curable HCC, and 2) survival following curative therapy. The study included 5670 chronic hepatitis B (1,077, 19.0%), C (4,196, 74.0%), or both (397, 7.0%)-infected patients enrolled in a prospective screening program. Screening was every 6 months with serum alpha-fetoprotein (AFP) measurement and ultrasonography. Curative treatments included liver transplantation, resection, RFA, and/or ethanol injection. HCC was diagnosed in 464 (8.2%) patients. Of 1006 cirrhotic patients, 462 (45.9%) developed HCC. Curative treatment was possible in 319 (68.7%). The 2- and 5-year overall survival rates in the curative treatment group were 65% and 28%, respectively, compared to 10% and 0% in the advanced disease group (p < 0.001). Prospective screening of patients at high risk to develop HCC increases the proportion diagnosed with potentially curable disease. This may result in an increase of the number of long-term survivors. A screening strategy should focus on those patients with chronic hepatitis B or C virus infection that has progressed to cirrhosis since more than 40% of these patients will develop HCC.

Can hepatocellular cancer screening increase theproportion of long-term survivors?

ORLANDO, RAFFAELE;
2009

Abstract

Historically, only 10% of hepatocellular cancer (HCC) patients are diagnosed with early stage, potentially curable disease. We prospectively screened chronic hepatitis virus-infected patients to determine 1) the proportion diagnosed with potentially curable HCC, and 2) survival following curative therapy. The study included 5670 chronic hepatitis B (1,077, 19.0%), C (4,196, 74.0%), or both (397, 7.0%)-infected patients enrolled in a prospective screening program. Screening was every 6 months with serum alpha-fetoprotein (AFP) measurement and ultrasonography. Curative treatments included liver transplantation, resection, RFA, and/or ethanol injection. HCC was diagnosed in 464 (8.2%) patients. Of 1006 cirrhotic patients, 462 (45.9%) developed HCC. Curative treatment was possible in 319 (68.7%). The 2- and 5-year overall survival rates in the curative treatment group were 65% and 28%, respectively, compared to 10% and 0% in the advanced disease group (p < 0.001). Prospective screening of patients at high risk to develop HCC increases the proportion diagnosed with potentially curable disease. This may result in an increase of the number of long-term survivors. A screening strategy should focus on those patients with chronic hepatitis B or C virus infection that has progressed to cirrhosis since more than 40% of these patients will develop HCC.
File in questo prodotto:
File Dimensione Formato  
hepatocellular cancer screening abstract.pdf

non disponibili

Tipologia: Abstract
Licenza: Accesso privato/ristretto
Dimensione 5.94 kB
Formato Adobe PDF
5.94 kB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/377781
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact