Surveillance programme for hepatocellular carcinoma improves the survival of patients with chronic viral hepatitis
Article first published online: 27 SEP 2007
Volume 28, Issue 1, pages 79–87, January 2008
How to Cite
Wong, G. L.-H., Wong, V. W.-S., Tan, G.-M., Ip, K.-I., Lai, W.-K., Li, Y.-W., Mak, M. S.-C., Lai, P. B.-S., Sung, J. J.-Y. and Chan, H. L.-Y. (2008), Surveillance programme for hepatocellular carcinoma improves the survival of patients with chronic viral hepatitis. Liver International, 28: 79–87. doi: 10.1111/j.1478-3231.2007.01576.x
- Issue published online: 27 SEP 2007
- Article first published online: 27 SEP 2007
- Received 22 April 2007accepted 24 July 2007
- hepatitis B;
Background: The survival benefit of surveillance for hepatocellular carcinoma (HCC) is controversial.
Aim: We aimed to examine the survival benefit of HCC surveillance in chronic viral hepatitis.
Methods: Survivals of HCC patients related to chronic viral hepatitis from the Hepatology Clinic (surveillance group) were compared with those referred from other hospitals/clinics (no-surveillance group). Lead-time and length-time biases were adjusted based on tumour volume doubling times.
Results: Among 579 patients (91% hepatitis B), 472 (82%) patients had HCC and 79 (17%) of these patients were referred from the surveillance programme. HCC was smaller (4.2 vs. 7.7 cm; P<0.001) and fewer in numbers (2.6 vs. 3.8, P=0.03) in the surveillance group vs. the no-surveillance group. Treatment by surgery (20 vs. 10%, P=0.007) and local ablative therapy (46 vs. 19%, P<0.001) were more frequent in the surveillance group than that in the no-surveillance group. The median survival of the surveillance group (88 weeks) was significantly longer than that of the no-surveillance group (26 weeks) (P<0.001). The adjusted cumulative survival at 2 years was significantly longer in the surveillance group if the tumour volume doubling time was <90 days (P=0.0352).
Conclusions: HCC surveillance can improve the survival of patients with chronic viral hepatitis B.