Masatoshi Kudo1, Namiki Izumi2, Michiie Sakamoto3, Yutaka Matsuyama4, Takafumi Ichida5, Osamu Nakashima6, Osamu Matsui7, Yonson Ku8, Norihiro Kokudo9, Masatoshi Makuuchi10. 1. Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka-Sayama, Tokyo, Japan. 2. Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino, Japan. 3. Department of Pathology, Keio University School of Medicine, Shinjuku, Japan. 4. Department of Biostatistics, School of Health Sciences and Nursing, University of Tokyo, Tokyo, Japan. 5. Department of Gastroenterology, Shizuoka Hospital Juntendo University School of Medicine, Shizuoka, Japan. 6. Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Japan. 7. Department of Radiology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan. 8. Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. 9. Department of Hepato-Biliary and Pancreatic Surgery, University of Tokyo Graduate School of Medicine, Tokyo, Japan. 10. Department of Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.
Abstract
BACKGROUND: Beginning in 1967, the Liver Cancer Study Group of Japan (LCSGJ) started a nationwide prospective registry of all patients with hepatocellular carcinoma (HCC) diagnosed at more than 700 institutions. To determine the effectiveness of surveillance and treatment methods longitudinally, we analyzed improvements over time in overall survival (OS) of 173,378 patients with HCC prospectively entered into the LCSGJ registry between 1978 and 2005. METHODS: All patients from more than 700 institutions throughout Japan with HCC were entered into the LCSGJ registry. Patients were grouped by years of diagnosis, with OS and 5-year OS rates being calculated. We also assessed OS and 5-year OS rates in patients who underwent resection, local ablation, transarterial chemoembolization (TACE), and hepatic arterial infusion chemotherapy (HAIC) and in those with baseline serum alpha-fetoprotein (AFP) levels ≥400 ng/ml. RESULTS: The 5- and 10-year OS rates in the cohort of 173,378 patients were 37.9% and 16.5%, respectively. However, over time, the mean maximum tumor size decreased significantly, whereas 5-year OS rates and median survival time increased significantly. Similar findings were observed separately in patients who underwent resection, local ablation, TACE, and HAIC, as well as in patients with AFP levels ≥400 ng/ml. CONCLUSION: The establishment of a nationwide HCC surveillance program in Japan has contributed to longer median OS and increased OS rates in patients diagnosed with this disease. These findings suggest that the establishment of a surveillance program in other countries with patients at risk for HCC may provide significant survival benefits.
BACKGROUND: Beginning in 1967, the Liver Cancer Study Group of Japan (LCSGJ) started a nationwide prospective registry of all patients with hepatocellular carcinoma (HCC) diagnosed at more than 700 institutions. To determine the effectiveness of surveillance and treatment methods longitudinally, we analyzed improvements over time in overall survival (OS) of 173,378 patients with HCC prospectively entered into the LCSGJ registry between 1978 and 2005. METHODS: All patients from more than 700 institutions throughout Japan with HCC were entered into the LCSGJ registry. Patients were grouped by years of diagnosis, with OS and 5-year OS rates being calculated. We also assessed OS and 5-year OS rates in patients who underwent resection, local ablation, transarterial chemoembolization (TACE), and hepatic arterial infusion chemotherapy (HAIC) and in those with baseline serum alpha-fetoprotein (AFP) levels ≥400 ng/ml. RESULTS: The 5- and 10-year OS rates in the cohort of 173,378 patients were 37.9% and 16.5%, respectively. However, over time, the mean maximum tumor size decreased significantly, whereas 5-year OS rates and median survival time increased significantly. Similar findings were observed separately in patients who underwent resection, local ablation, TACE, and HAIC, as well as in patients with AFP levels ≥400 ng/ml. CONCLUSION: The establishment of a nationwide HCC surveillance program in Japan has contributed to longer median OS and increased OS rates in patients diagnosed with this disease. These findings suggest that the establishment of a surveillance program in other countries with patients at risk for HCC may provide significant survival benefits.
Entities:
Keywords:
Hepatic arterial infusion chemotherapy; Hepatocellular carcinoma; Liver Cancer Study Group of Japan; Nationwide survey; Overall survival
Authors: S Eguchi; T Kanematsu; S Arii; M Omata; M Kudo; M Sakamoto; K Takayasu; M Makuuchi; Y Matsuyama; M Monden Journal: Br J Surg Date: 2011-01-25 Impact factor: 6.939
Authors: Josep M Llovet; Sergio Ricci; Vincenzo Mazzaferro; Philip Hilgard; Edward Gane; Jean-Frédéric Blanc; Andre Cosme de Oliveira; Armando Santoro; Jean-Luc Raoul; Alejandro Forner; Myron Schwartz; Camillo Porta; Stefan Zeuzem; Luigi Bolondi; Tim F Greten; Peter R Galle; Jean-François Seitz; Ivan Borbath; Dieter Häussinger; Tom Giannaris; Minghua Shan; Marius Moscovici; Dimitris Voliotis; Jordi Bruix Journal: N Engl J Med Date: 2008-07-24 Impact factor: 91.245