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A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Surveillance programme for hepatocellular carcinoma improves the survival of patients with chronic viral hepatitis
Grace Lai-Hung Wong1, Vincent Wai-Sun Wong, Guang-Ming Tan
1Institute of Digestive Disease and Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China.
Insights
Hepatocellular carcinoma (HCC) surveillance improves survival in patients with chronic viral hepatitis B. Early detection leads to smaller tumors, more treatment options, and significantly longer median survival.
Area of Science:
- Hepatology
- Oncology
- Viral Hepatitis Research
Background:
- The survival benefit of hepatocellular carcinoma (HCC) surveillance remains a subject of debate.
- Chronic viral hepatitis, particularly hepatitis B, is a major risk factor for HCC development.
Purpose of the Study:
- To investigate the survival advantage of HCC surveillance in patients with chronic viral hepatitis.
- To compare outcomes between patients monitored through a surveillance program and those without.
Main Methods:
- A comparative study of HCC patients with (surveillance group) and without (no-surveillance group) chronic viral hepatitis.
- Adjustment for lead-time and length-time biases using tumor volume doubling times.
- Analysis of survival data, tumor characteristics, and treatment modalities.
Main Results:
- Patients in the surveillance group had smaller (4.2 vs. 7.7 cm) and fewer (2.6 vs. 3.8) HCC tumors.
- More frequent surgical (20% vs. 10%) and ablative therapies (46% vs. 19%) were observed in the surveillance group.
- Median survival was significantly longer in the surveillance group (88 weeks vs. 26 weeks), with improved 2-year survival for tumors with doubling time <90 days.
Conclusions:
- Hepatocellular carcinoma surveillance is associated with improved survival in patients with chronic viral hepatitis B.
- Early detection through surveillance facilitates timely and effective treatment, enhancing patient outcomes.
Background:
The survival benefit of surveillance for hepatocellular carcinoma (HCC) is controversial.
Aim:
We aimed to examine the survival benefit of HCC surveillance in chronic viral hepatitis.
Methods:
Survivals of HCC patients related to chronic viral hepatitis from the Hepatology Clinic (surveillance group) were compared with those referred from other hospitals/clinics (no-surveillance group). Lead-time and length-time biases were adjusted based on tumour volume doubling times.
Results:
Among 579 patients (91% hepatitis B), 472 (82%) patients had HCC and 79 (17%) of these patients were referred from the surveillance programme. HCC was smaller (4.2 vs. 7.7 cm; P<0.001) and fewer in numbers (2.6 vs. 3.8, P=0.03) in the surveillance group vs. the no-surveillance group. Treatment by surgery (20 vs. 10%, P=0.007) and local ablative therapy (46 vs. 19%, P<0.001) were more frequent in the surveillance group than that in the no-surveillance group. The median survival of the surveillance group (88 weeks) was significantly longer than that of the no-surveillance group (26 weeks) (P<0.001). The adjusted cumulative survival at 2 years was significantly longer in the surveillance group if the tumour volume doubling time was <90 days (P=0.0352).
Conclusions:
HCC surveillance can improve the survival of patients with chronic viral hepatitis B.
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