Korean J Hepatol > Volume 9(2); 2003 > Article
The Korean Journal of Hepatology 2003;9(2): 116-123.
Early Diagnosis and Improved Survival with Screening for Hepatocellular Carcinoma
Chung Mee Youk, M.D., Moon Seok Choi, M.D., Seung Woon Paik, M.D., Byeong Hoon Ahn, M.D., Joon Hyeok Lee, M.D., Kwang Cheol Koh, M.D., Byung Chul Yoo, M.D. and Jong Chul Rhee, M.D.
Division of Gastroenterology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
ABSTRACT
Background/Aims
Screening for hepatocellular carcinoma (HCC) is a common practice in the endemic countries but its exact role has not been fully investigated. The purpose of this study was to determine whether screening can achieve early diagnosis and survival benefits. Methods: All HCC patients diagnosed at our hospital (September 1994∼April 2000) were enrolled; They were divided into two groups; a pre- screening group screened with alpha-fetoprotein and ultrasound for longer than 6 months before diagnosis and a non pre-screening group. We compared the tumor size, portal vein thrombosis, and stage at initial diagnosis and survival rate between the two groups. Results: A total of 247 patients were enrolled. 64 were in the non pre-screening group and 183 were in the non pre-screening group. The tumor size at initial diagnosis in the pre-screening group was smaller than in the non pre-screening group (2.6±2.0 cm vs. 5.7±4.1 cm, p<0.05). The percentages of patients with stage I, II, III, and IV were 42.2%, 20.3%, 14.1%, 23.4% in the pre-screening group and 8.7%, 19.7%, 36.6%, 35.0% in the non pre-screening group. A significantly higher proportion in the pre-screening group had earlier stage compared with the non pre-screening group (p<0.05). Portal vein thrombosis in the pre-screening group was noticed as significantly less than in the non pre-screening group (9.4% vs. 26.8%, p<0.05). Among Child A patients, the cumulative survival rate in the pre-screening group was significantly higher than in the non pre-screening group (1 year; 91.4% vs. 70.7%, 2 year; 71.5% vs. 59.9%, p<0.05). Conclusions: Screening with AFP and US is a useful tool for early diagnosis of HCC, especially with improved survival in Child A patients.(Korean J Hepatol 2003;9:116-123)
KeyWords: Neoplasm/Liver/Hepatocellular carcinoma, Screening

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