Optimal treatment increased survival of hepatocellular carcinoma patients detected with community‐based screening |
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Authors: | Po‐Lin Tseng Jing‐Houng Wang Hung‐Da Tung Chao‐Hung Hung Kwong‐Ming Kee Chien‐Hung Chen Kuo‐Chin Chang Chuan‐Mo Lee Chi‐Sin Changchien Pao‐Fei Chen Lin‐San Tsai Sheng‐Nan Lu |
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Affiliation: | 1. Division of Hepato‐Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital‐Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Tainan,;2. Division of Gastroenterology, Department of Internal Medicine, Chi Mei Medical Center Liouying, Tainan,;3. Tainan County Health Bureau, Sinying, Taipei, Taiwan |
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Abstract: | Background and Aim: The early detection of hepatocellular carcinoma (HCC) and opportunity to select appropriate treatment are important benefits of HCC screening. Our aim in the present study was to investigate the survival rate, prognostic factors and treatment effects in HCC patients of community‐based screening. Methods: Community‐based ultrasound (US) screening for HCC in adults with platelet counts (< 150 × 103/mm3) and/or alpha fetoprotein (AFP) > 20 ng/mL was conducted in 2002 and 2004. As per the Barcelona Clinic Liver Cancer (BCLC) stage, 90 cases of intermediate or earlier stage HCC were detected and 88 cases had sufficient information for analysis (49 men and 39 women, aged 65.8 ± 9.6 years). The tumor diameter was mostly less than 5 cm (76.1%). The follow up was continued until June 2008. Results: The 4‐year overall survival rate was 46.8%. Old age (≥ 70 years) (P = 0.046), later stage of HCC (intermediate vs earlier) (P = 0.012), low platelet count (< 100 × 103/mm3) (P = 0.013) and refusal of modern treatment (P = 0.026) were independent poor prognostic factors. Curative treatment increased survival in patients of all ages. Both curative treatment and transcatheter arterial embolization (TAE) increased survival in cases of intermediate HCC. However, treatment benefits were not found for patients with (very) early stage HCC. Conclusions: Early detection and prompt treatment of HCC leads to increased survival. For elderly patients this benefit was seen only for early stage cases receiving curative treatment. Differences between treatment types for patients with (very) early stage HCC might emerge with a longer follow‐up period. |
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Keywords: | advanced age Barcelona Clinic Liver Cancer stage community screening curative treatment hepatocellular carcinoma |
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