Surveillance of hepatocellular carcinoma in patients with hepatitis C virus infection may improve patient survival

Hironori Tanaka, Kazuhiro Nouso, Haruhiko Kobashi, Yoshiyuki Kobayashi, Shin Ichiro Nakamura, Yasuhiro Miyake, Hideki Ohnishi, Kenji Miyoshi, Shouta Iwado, Yoshiaki Iwasaki, Kohsaku Sakaguchi, Yasushi Shiratori

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33 Citations (Scopus)

Abstract

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. 35mm) 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.

Original languageEnglish
Pages (from-to)543-551
Number of pages9
JournalLiver International
Volume26
Issue number5
DOIs
Publication statusPublished - Jun 1 2006

Keywords

  • Hepatitis C
  • Hepatocellular carcinoma
  • Lead-time bias
  • Screening
  • Ultrasonography
  • α-fetoprotein

ASJC Scopus subject areas

  • Hepatology

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    Tanaka, H., Nouso, K., Kobashi, H., Kobayashi, Y., Nakamura, S. I., Miyake, Y., Ohnishi, H., Miyoshi, K., Iwado, S., Iwasaki, Y., Sakaguchi, K., & Shiratori, Y. (2006). Surveillance of hepatocellular carcinoma in patients with hepatitis C virus infection may improve patient survival. Liver International, 26(5), 543-551. https://doi.org/10.1111/j.1478-3231.2006.01270.x