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A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Recent progress in the management of hepatocellular carcinoma detected during a surveillance program in Japan
Masahito Nakano1, Eiji Ando, Ryoko Kuromatsu
1Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume Department of Internal Medicine, Inoue Hospital, Maebaru Department of Internal Medicine, Kurume University Medical Center, Kurume, Fukuoka, Japan.
Insights
Recent advancements in hepatocellular carcinoma (HCC) management have improved outcomes for patients diagnosed during surveillance. Improved treatment and prognosis are evident in recent years for HCC surveillance cases.
Area of Science:
- Hepatology
- Oncology
- Medical Surveillance
Background:
- Hepatocellular carcinoma (HCC) management has seen significant evolution.
- Early detection through surveillance is crucial for improving patient outcomes.
- Understanding recent management improvements in HCC is vital for clinical practice.
Purpose of the Study:
- To explore recent improvements in the management of hepatocellular carcinoma (HCC).
- To analyze changes in HCC diagnosis and treatment over time.
- To assess the impact of surveillance on HCC management and prognosis.
Main Methods:
- Retrospective analysis of 1074 patients with HCC.
- Patients categorized into three groups: surveillance at a specific institution (Group A), surveillance at other institutions (Group B), and incidental/symptomatic diagnosis (Group C).
- Comparison of Milan criteria, Child-Pugh class, treatment utilization, and survival rates between different periods and diagnostic groups.
Main Results:
- Patients diagnosed via surveillance (Groups A & B) consistently met Milan criteria more often than incidentally diagnosed patients (Group C).
- Improved Child-Pugh class A status and increased use of promising treatments were observed in later periods for surveillance-detected HCC.
- Cumulative survival rates showed a trend towards improvement for HCC detected in the latter 6-year period.
Conclusions:
- The management and prognosis for hepatocellular carcinoma (HCC) diagnosed through surveillance have improved in recent years.
- Enhanced surveillance strategies correlate with better patient selection for treatment and improved survival.
- Continued focus on surveillance and timely intervention is key for optimizing HCC patient outcomes.
Aim:
This study explored recent improvements in the management of hepatocellular carcinoma (HCC) diagnosed during surveillance.
Methods:
The subjects were 1074 patients with HCC, subdivided into three groups. Group A comprised 211 patients for whom HCC was detected during periodic follow-up examinations at Kurume University School of Medicine, Group B comprised 544 patients diagnosed with HCC during periodic follow-up examinations at other institutions, and, Group C comprised 319 patients with HCC detected incidentally or because of symptoms.
Results:
In 1995-2000 and 2001-2006, 91% and 91% of group A, 68% and 70% of group B, and 27% and 26% of group C patients with HCC, respectively, met the Milan criteria. For groups A and B, the proportions of patients with Child-Pugh class A and use of promising treatment increased in the later periods compared to those diagnosed during the earlier periods (group A, Child-Pugh class A, 72% vs 58% [P = 0.040], receiving treatment, 90% vs 70% [P < 0.0001]; group B, Child-Pugh class A, 71% vs 62% [P = 0.031]; receiving treatment, 72% vs 52% [P < 0.0001], respectively). The cumulative survival rates of the 405 patients with HCC detected in the latter 6 years tended to be better than those for patients diagnosed in the former 6 years (350 patients) (4 years, 58% vs 50% [P = 0.0349]).
Conclusion:
The use of promising treatment and prognosis have improved in the last 6 years for patients with HCC diagnosed through surveillance relative to those identified in 1995-2000.
