Background/Aim s: The National Liver Cancer Screening Program (NLCSP) has been implemented for the past 15 years in Korea. However, the actual clinical experience in Korea is inconsistent with the expectations of the hepatocellular carcinoma (HCC) surveillance program. To evaluate the actual clinical situation of HCC diagnoses, we investigated disease severity in patients with HCC and the diagnostic environment.
Methods From January 2011 to December 2015, all patients who were diagnosed with HCC in a single secondary hospital in Daejeon city were retrospectively enrolled in this study. Severity of HCC was evaluated according to the Barcelona Clinic Liver Cancer (BCLC) staging system.
Results Over the course of 5 years, 298 participants were enrolled. The mean age of participants was 64.0 years. Positive hepatitis B surface antigen was confirmed in 134 patients (45.0%), 35 patients (11.7%) tested positive for anti-hepatitis C virus antibody, and 93 patients (32.2%) had more than 40 g/day of alcohol consumption. The proportions of patients according to BCLC stages were as follows: BCLC-0, 28 patients (9.4%); BCLC-A, 42 patients (14.1%); BCLC-B, 26 patients (8.7%); BCLC-C, 134 patients (45.0%); and BCLC-D, 68 patients (22.8%). The diagnostic environments were as follows: 19 patients were in the NLCSP group (6.4%), 114 in the group with presenting signs (38.3%), 110 in the regular outpatient care group (36.9%), and 55 patients in the incidental diagnosis group (18.5%).
Conclusions Most patients (67.8%) had advanced stage HCC at diagnosis, and curative treatment was not indicated due to the severity disease. Thus, the actual situation is far worse than the theoretical expectation of HCC surveillance, suggesting that many high-risk patients for HCC are missed in surveillance.
Citations
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NCA‐GA‐SVM: A new two‐level feature selection method based on neighborhood component analysis and genetic algorithm in hepatocellular carcinoma fatality prognosis Wojciech Książek, Filip Turza, Paweł Pławiak International Journal for Numerical Methods in Biomedical Engineering.2022;[Epub] CrossRef
Imaging Modalities for Hepatocellular Carcinoma Surveillance: Expanding Horizons beyond Ultrasound Hyo Jung Park, So Yeon Kim Journal of Liver Cancer.2020; 20(2): 99. CrossRef
Background/Aim s: To optimize efficacy of National Liver Cancer Screening Program (NLCSP)
for subjects with chronic hepatitis B (CHB), it is needed to know the incidence of liver cancer
and its predisposing factors in the program.
Methods From January 2010 to December 2014, all the hepatitis B surface antigen (HBsAg)
positive participants who received at least two or more abdominal ultrasonography under
NLCSP were retrospectively enrolled in a single tertiary hospital. Annual incidence of primary
liver cancer was calculated and related clinical factors were investigated.
Results During 5 years, 541 subjects were enrolled. Mean age was 53 years old and 292
subjects (54%) were receiving antiviral agents. Liver cirrhosis (LC) was diagnosed in 212 (39.2%).
Mean follow-up time was 2.36 years and 15 hepatocellular carcinoma and 1 intrahepatic
cholangiocarcinoma were diagnosed. Annual incidence of primary liver cancer was 9.8
per 1,000 patient year. Cumulative incidence at 1, 3, and 5 year was 0.6%, 2.6%, and 6.4%,
respectively. In multivariate analyses, LC (hazard ratio [HR] 8.74, 95% confidence interval [CI]
1.97–38.71, P=0.024), age (HR 1.08, 95% CI 1.01–1.15, P=0.024) were significantly associated
with cancer development.
Conclusions Despite of high rate of oral antiviral therapy, incidence of primary liver cancer
is not low in CHB patients in Korea. Old age and presence of LC are independently associated
with higher risk of cancer development during surveillance. This study could be used as
baseline data for quality control of NLCSP.
Citations
Citations to this article as recorded by
Effectiveness of Hepatocellular Carcinoma Surveillance and an Optimal Surveillance Interval: Nationwide Cohort of Korea Heejin Bae, Sang Ah Lee, Jong Won Choi, Shin Hye Hwang, Sumi Park, Mi-Suk Park Yonsei Medical Journal.2021; 62(8): 758. CrossRef
A Survey of Liver Cancer Specialists’ Views on the National Liver Cancer Screening Program in Korea Won Sohn, Young-Sun Lee, Jae Geun Lee, Jihyun An, Eun Sun Jang, Dong Ho Lee, Dong Hyun Sinn Journal of Liver Cancer.2020; 20(1): 53. CrossRef
Discrepancy between the Actual Clinical Status of Patients with Hepatocellular Carcinoma and Expectations from Hepatocellular Carcinoma Surveillance: a Single-Center Study Nak Min Kim, Young Seok Doh, Ji Woong Jang, Seok-Hwan Kim, Hyuk Soo Eun, Jae Hyuck Jun, Sae Hee Kim, Il Hyun Baek, Sung Hee Jung Journal of Liver Cancer.2019; 19(1): 30. CrossRef