Abstract

HCC is an appropriate cancer to apply surveillance program for early cancer detection. Currently, liver ultrasonography (US) combined with serum biomarker, alpha‐fetoprotein (AFP), measurement every 6 months is the standard method of HCC surveillance. Although US is the most widely used tool, its sensitivity in early HCC (within Milan criteria) detection during surveillance is only 63%. AFP is the representative biomarker for both HCC surveillance and diagnosis. The unsatisfactory performance of AFP as a surveillance tool requires discovery of novel biomarker or combination with other serum markers. Desgamma‐ carboxy prothrombin (DCP) and AFP‐L3 are candidate biomarkers which are complementary to AFP. AFP‐L3 is an emerging biomarker for diagnosis of HCC, but it needs to be validated as a surveillance tool. Regarding surveillance interval, 6 months or less seems to be superior to more longer interval in terms of early HCC detection and survival improvement. The strategies of HCC surveillance are different in countries according to health care system including available resources and health insurance coverage. Many studies demonstrated that rate of early cancer detection and application of curative therapies was increased, along with survival benefit, by HCC surveillance which is now the standard care, not just a recommendation. Improved ultrasound technology and biomarker discovery such as a specific microRNA are necessary to make more progress in HCC surveillance.

• Keywords: Hepatcellular carcinoma;Surveillance;Survival