Can hepatocellular cancer screening increase the proportion of long-term survivors?
| Autor: | Gannon CJ, Izzo F, Aloia TA, Pignata S, Nasti G, Vallone P, Scordino F, Curley S.A., ORLANDO, RAFFAELE |
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| Přispěvatelé: | Gannon, Cj, Izzo, F, Aloia, Ta, Pignata, S, Nasti, G, Vallone, P, Orlando, Raffaele, Scordino, F, Curley, S. A. |
| Rok vydání: | 2009 |
| Předmět: |
Adult
Aged 80 and over Carcinoma Hepatocellular Chi-Square Distribution Hepatocellular carcinoma viral hepatiti screening Liver Neoplasms Hepatitis C Chronic Middle Aged Survival Rate Hepatitis B Chronic Humans Mass Screening Survivors alpha-Fetoproteins Neoplasm Recurrence Local Aged Ultrasonography |
| Zdroj: | Hepato-gastroenterology. 56(93) |
| ISSN: | 0172-6390 |
| Popis: | Historically, only 10% of hepatocellular cancer (HCC) patients are diagnosed with early stage, potentially curable disease. We prospectively screened chronic hepatitis virus-infected patients to determine 1) the proportion diagnosed with potentially curable HCC, and 2) survival following curative therapy. The study included 5670 chronic hepatitis B (1,077, 19.0%), C (4,196, 74.0%), or both (397, 7.0%)-infected patients enrolled in a prospective screening program. Screening was every 6 months with serum alpha-fetoprotein (AFP) measurement and ultrasonography. Curative treatments included liver transplantation, resection, RFA, and/or ethanol injection. HCC was diagnosed in 464 (8.2%) patients. Of 1006 cirrhotic patients, 462 (45.9%) developed HCC. Curative treatment was possible in 319 (68.7%). The 2- and 5-year overall survival rates in the curative treatment group were 65% and 28%, respectively, compared to 10% and 0% in the advanced disease group (p < 0.001). Prospective screening of patients at high risk to develop HCC increases the proportion diagnosed with potentially curable disease. This may result in an increase of the number of long-term survivors. A screening strategy should focus on those patients with chronic hepatitis B or C virus infection that has progressed to cirrhosis since more than 40% of these patients will develop HCC. |
| Databáze: | OpenAIRE |
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