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Surveillance Program for Early Detection of Hepatocellular Carcinoma in Japan: Results of Specialized Department of Liver Disease

Ando, Eiji MD*; Kuromatsu, Ryoko MD*; Tanaka, Masatoshi MD; Takada, Akio MD*; Fukushima, Nobuyoshi MD*; Sumie, Shuji MD*; Nagaoka, Sakae MD*; Akiyoshi, Jyunji MD*; Inoue, Kinya MD*; Torimura, Takuji MD*; Kumashiro, Ryukichi MD*; Ueno, Takato MD; Sata, Michio MD*

Journal of Clinical Gastroenterology: November-December 2006 - Volume 40 - Issue 10 - p 942-948
doi: 10.1097/01.mcg.0000225675.14594.d6
Liver, Pancreas, and Biliary Tract: Clinical Research

Objective Surveillance of cirrhotic patients enables early detection of hepatocellular carcinoma (HCC) and possibly prolongs survival. The aim of this study was to explore whether early-stage HCC can be detected earlier at a specialized department of liver disease than in other institutions.

Methods The study subjects were 574 patients with HCC. Patients were subdivided into 3 groups according to the manner of HCC detection: group A, HCC was detected in 91 patients during periodic examination at Kurume University School of Medicine; group B, HCC was detected in 301 patients during periodic examination at other institutions; group C, HCC was detected incidentally or because of symptoms in 182 patients.

Results The HCC detected in group A was significantly of smaller size (20.4 mm) compared with groups B (27.1 mm, P<0.0001) and C (57.8 mm, P<0.0001). The frequency of receiving treatment (surgery or local ablation therapy) was significantly higher in group A (73%) than in groups B (52%, P=0.002) and C (26%, P<0.0001). The 5-year survival rates were 52% for group A, 40% for group B, and 23% for group C, respectively. The survival of group A was significantly better than that of groups B (P=0.0157) and C (P<0.0001).

Conclusions Surveillance for HCC at specialized Department of Liver Disease can detect early-stage HCC, resulting in a higher chance of receiving promising treatment.

*Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine

Research Center for Innovative Cancer therapy, and Center of the 21th Century Center of Excellence Program for Medical Science

Department of Internal Medicine, Kurume University Medical Center, Kurume city, Fukuoka, Japan

Reprints: Eiji Ando, MD, Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume-shi, Fukuoka-ken, 830-0011, Japan (e-mail:

Received for publication January 26, 2006; accepted June 9, 2006

© 2006 Lippincott Williams & Wilkins, Inc.