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Survival of Hepatocellular Carcinoma Patients May be Improved in Surveillance Interval not More Than 6 Months Compared With More Than 6 Months: A 15-Year Prospective Study

Authors
 Kwang-Hyub Han ; Do Young Kim ; Chae Yoon Chon ; Kwan Sik Lee ; Ja Kyung Kim ; Seung Up Kim ; Jieun Kim ; Sang Hoon Ahn ; Jun Yong Park 
Citation
 Journal of Clinical Gastroenterology, Vol.47(6) : 538~544, 2013 
Journal Title
 Journal of Clinical Gastroenterology 
ISSN
 0192-0790 
Issue Date
2013
Abstract
GOALS: To compare hepatocellular carcinoma (HCC) stage, treatment modality, and survival between groups submitted to different surveillance interval. BACKGROUND: It is not clear if surveillance interval affects patient survival with HCC. STUDY: Clinical data from 10,307 patients at risk for HCC were prospectively collected from 1990 to 2005. The characteristics of cancer and 5-year survival in patients diagnosed as HCC during follow-up were compared between surveillance interval of <6 months and beyond 6 months. RESULTS: A total of 400 patients were diagnosed with HCC, with a mean tumor size of 3.5 cm and an annual detection rate of 2.4%. The tumor sizes detected in patients with surveillance interval ≤ 6 months were significantly smaller than those detected in patients with interval of >6 months (n=219; 3.0 ± 1.7 cm vs. n=181; 4.0 ± 2.6 cm, P<0.001). The survival benefit in patients with surveillance interval of ≤ 6 months was significant compared with those with interval of >6 months even after considering lead time with assumed tumor doubling time of 60 days. The 5-year survival of HCC patients surveyed between 2000 and 2004 was significantly higher compared with those surveyed between 1990 and 1994 or between 1995 and 1999 (41% vs. 17% and 19%, respectively, P<0.0001). Using a Cox regression model, Child-Pugh class, Japanese tumor-node-metastasis stage, and α-fetoprotein levels were independently associated with patient survival. CONCLUSIONS: Our data show that surveillance ≤ 6 months might be associated with early detection of HCC and improved survival in a hepatitis B endemic area.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/87232
DOI
10.1097/MCG.0b013e3182755c13
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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 http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00004836-201307000-00016&LSLINK=80&D=ovft
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