Regular surveillance by imaging for early detection and better prognosis of hepatocellular carcinoma in patients infected with hepatitis C virus

• DOI: 10.1007/s00535-009-0131-x
• Publication Date: 2009-10-28T16:17:08Z
• Authors: Ikue Noda; Mikiya Kitamoto; Hideki Nakahara; Ryohei Hayashi; Tomoaki Okimoto; Yoshio Monzen; Hiroyasu Yamada; Masaru Imagawa; Nobuhiko Hiraga; Junko Tanaka; Kazuaki Chayama
• Keywords: Aged, 80 and over; Male; Carcinoma, Hepatocellular; Liver Neoplasms; Contrast Media; Middle Aged; Prognosis; Hepatitis C; 3. Good health; Survival Rate; 03 medical and health sciences; Early Diagnosis; Treatment Outcome; 0302 clinical medicine; Humans; Mass Screening; Female; Aged; Neoplasm Staging; Retrospective Studies

This study evaluated the usefulness of regular check-ups by ultrasonography and contrast-enhanced imaging for early detection of hepatocellular carcinoma (HCC) in a retrospective analysis.From April 2001 to March 2007, 240 consecutive patients with HCC who were infected with hepatitis C virus (HCV) were divided into three groups. Patients diagnosed with HCC by repeated imaging constituted Group A (surveillance group). Group B comprised patients in whom HCC was detected during scheduled doctor visits for liver disease or other diseases such as diabetes. Group C comprised non-screened patients.The prevalence of solitary tumors decreased from Group A through Group B to Group C (66, 48 and 24%, respectively, P < 0.001). The proportion of patients in stages I and II decreased from 83% (103/124) in Group A to 53% (42/79) in Group B and 24% (9/37) in Group C (P < 0.001). The proportion of patients who were treated with curative procedures, such as resection or ablation, was highest at 80% (99/124) in Group A, and lower at 53% (42/79) in Group B and 27% (10/37) in Group C (P < 0.001). The cumulative survival rate was better in Group A than B (P < 0.05), and in Group B than C (P < 0.001). Periodical medical check-ups without imaging did not necessarily detect early-stage disease, even when HCC-related markers including des-gamma-carboxy prothrombin were tested.Regular surveillance with ultrasonography and contrast-enhanced imaging is useful for detecting early-stage HCC and increase chances for curative treatments in patients with HCV-related chronic liver disease.