Changing paradigm in the management of hepatocellular carcinoma improves the survival benefit of early detection by screening.

Abstract:

OBJECTIVE:To evaluate the impact of improved surgical management of hepatocellular carcinoma (HCC) on the survival of patients with screened HCC. SUMMARY BACKGROUND DATA:It is unclear whether the advent of new treatment modalities such as liver transplantation and radiofrequency ablation (RFA) in recent years have improved the long-term survival in patients with HCC detected by screening. METHODS:A prospective database of 1366 patients with known chronic hepatitis B or C virus infection diagnosed with HCC either by screening or symptomatic presentation from January 1991 to December 2004 was reviewed. The long-term survival of HCC patients in the screened and symptomatic groups was compared. The management and survival of patients in two 7-year periods (1991-1997 vs. 1998-2004) were further compared. RESULTS:Long-term survival was significantly better in the screened group than in the symptomatic group (median survival 61.9 vs. 11.5 months, P < 0.001). The proportion of patients with curative treatment increased from 50.5% in the first period to 67.8% in the second period in the screened group, but there was no significant change in the symptomatic group. Improved long-term survival was observed in patients with HCC detected by screening and treated in the second period compared with the first period (median survival 68.5 vs. 38.7 months, P = 0.022), but no significant improvement was observed for symptomatic patients. CONCLUSION:Survival of patients with HCC detected by screening has improved in recent years due to increased chance of curative treatment with the advent of liver transplantation and RFA.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Chan AC,Poon RT,Ng KK,Lo CM,Fan ST,Wong J

doi

10.1097/SLA.0b013e31816a747a

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

666-73

issue

4

eissn

0003-4932

issn

1528-1140

pii

00000658-200804000-00014

journal_volume

247

pub_type

杂志文章
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    authors: Toiyama Y,Hur K,Tanaka K,Inoue Y,Kusunoki M,Boland CR,Goel A

    更新日期:2014-04-01 00:00:00

  • Randomized Trial of Laparoscopic Nissen vs. Anterior 180 Degree Partial Fundoplication - Late Clinical Outcomes at 15-20 years.

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  • The impact of perioperative risk, tumor pathology and surgical complications on disease recurrence following potentially curative resection of colorectal cancer.

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    doi:10.1097/00000658-200102000-00003

    authors: Rogers DA,Elstein AS,Bordage G

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    authors: Kamenskiy A,Aylward P,Desyatova A,DeVries M,Wichman C,MacTaggart J

    更新日期:2020-01-03 00:00:00

  • Transvenous management of pulmonary embolic disease.

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    authors: Greenfield LJ,Peyton MD,Brown PP,Elkins RC

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    journal_title:Annals of surgery

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    authors: Hirsch JC,Goldberg C,Bove EL,Salehian S,Lee T,Ohye RG,Devaney EJ

    更新日期:2008-09-01 00:00:00

  • Acute Kidney Injury in Burn Patients: Clinically Significant Over the Initial Hospitalization and 1 Year After Injury: An Original Retrospective Cohort Study.

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    doi:10.1097/SLA.0000000000001979

    authors: Thalji SZ,Kothari AN,Kuo PC,Mosier MJ

    更新日期:2017-08-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验

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    pub_type: 杂志文章,随机对照试验

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    pub_type: 临床试验,杂志文章

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    更新日期:1997-09-01 00:00:00

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    journal_title:Annals of surgery

    pub_type: 杂志文章

    doi:10.1097/00000658-198509000-00007

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    pub_type: 杂志文章

    doi:

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    pub_type: 杂志文章,随机对照试验

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    authors: Prasad AS,Gupta S,Kohli V,Pande GK,Sahni P,Nundy S

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    doi:10.1097/00000658-197501000-00012

    authors: Dawidson I,Barrett JA,Miller E,Litwin MS

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    authors: Atisha D,Alderman AK,Lowery JC,Kuhn LE,Davis J,Wilkins EG

    更新日期:2008-06-01 00:00:00