Hepatocellular Carcinoma: Trends of Incidence and Survival in Europe and the United States at the End of the 20th Century

Capocaccia, Riccardo; Sant, Milena; Berrino, Franco; Simonetti, A; Santi, Valentina; Trevisani, Franco

doi:10.1111/j.1572-0241.2007.01337.x

Cited by 126 publications

(92 citation statements)

References 32 publications

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“…[1][2][3] As in previous studies, 6,[10][11][12][16][17][18] RFA of the initial HCC nodules produced CRs in over 98% of the cases, with a local recurrence rate of about 15%, even if the technique used was not performed to obtain safety margins. The latter requires multiple electrode insertions and overlapping thermal lesions 28 that are difficult to create even for skilled operators.…”

Section: Discussionmentioning

confidence: 69%

“…1 Most HCC patients have underlying cirrhosis, which complicates management of their cancer and is often the direct cause of death. 2 Internationally endorsed guidelines currently recommend surgical resection for early-stage HCCs in patients with well-preserved liver function. 3,4 When surgery is not possible, there are several minimally invasive options for chemical or thermal tumor ablation.…”

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confidence: 99%

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Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: A long-term cohort study

et al. 2011

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In most patients with cirrhosis, successful percutaneous ablation or surgical resection of hepatocellular carcinoma (HCC) is followed by recurrence. Radiofrequency ablation (RFA) has proven effective for treating HCC nodules, but its repeatability in managing recurrences and the impact of this approach on survival has not been evaluated. To this end, we retrospectively analyzed a prospective series of 706 patients with cirrhosis (ChildPugh class B7) who underwent RFA for 859 HCC 35 mm in diameter (1-2 per patient). The results of RFA were classified as complete responses (CRs) or treatment failures. CRs were obtained in 849 nodules (98.8%) and 696 patients (98.5%). During follow-up (median, 29 months), 465 (66.8%) of the 696 patients with CRs experienced a first recurrence at an incidence rate of 41 per 100 person-years (local recurrence 6.2; nonlocal 35). Cumulative incidences of first recurrence at 3 and 5 years were 70.8% and 81.7%, respectively. RFA was repeated in 323 (69.4%) of the 465 patients with first recurrence, restoring disease-free status in 318 (98.4%) cases. Subsequently, RFA was repeated in 147 (65.9%) of the 223 patients who developed a second recurrence after CR of the first, restoring disease-free status in 145 (98.6%) cases. Overall, there were 877 episodes of recurrence (1-8 per patient); 577 (65.8%) of these underwent RFA that achieved CRs in 557 (96.5%) cases. No procedure-related deaths occurred in 1,921 RFA sessions. Estimated 3-and 5-year overall and disease-free (after repeated RFAs) survival rates were 67.0% and 40.1% and 68.0 and 38.0%, respectively. Conclusion: RFA is safe and effective for managing HCC in patients with cirrhosis, and its high repeatability makes it particularly valuable for controlling intrahepatic recurrences. (HEPATOLOGY 2011;53:136-147)

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Section: Discussionmentioning

confidence: 69%

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confidence: 99%

Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: A long-term cohort study

et al. 2011

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“…HCC is one of the most common cancers worldwide [1][2][3][4]. Most HCC patients have a chronic liver disease in the background liver, among which chronic viral hepatitis due to hepatitis C virus (HCV) or hepatitis B virus (HBV) is very common [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Ultrasound surveillance for early detection of hepatocellular carcinoma among patients with chronic hepatitis C

et al. 2009

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Background and aims Ultrasonography is the most frequently used modality in surveillance for HCC among patients with chronic hepatitis C. However, the optimal surveillance interval is still controversial and the usefulness of supplementary tumor marker determination has not been confirmed. Methods A total of 243 cases of naive HCC were detected among 1,431 patients with chronic hepatitis C under outpatient-based surveillance. The mode of HCC detection, including ultrasound surveillance interval, was retrospectively examined and the relation between the interval and detected tumor size was analyzed. Tumor volume doubling time was estimated from exponential increase in serum tumor marker levels when applicable. Results HCC was first detected by ultrasonography in 221 patients. Ultrasound surveillance interval, ranging between 2 and 8 months, was not correlated with the size of tumor at detection. Patients with cirrhosis were likely to be surveyed at shorter intervals. The size of tumor exceeded 30 mm only in three (1.4%) cases. They were all positive for a biomarker and the estimated tumor doubling time was short. In 14 cases, HCC was first detected by CT indicated by abnormal rise in tumor marker levels despite negative ultrasound findings. In the remaining eight cases, ultrasonography had been replaced by CT as surveillance modality because of excessive obesity or coarseness of liver parenchyma.Conclusions Ultrasound surveillance at 6-month intervals was appropriate in general for the detection of HCC at a size smaller than 30 mm. However, in patient with established cirrhosis, more frequent screening would be needed to detect tumors of the same size.

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“…It is recognized as the leading cause of death in the compensated phase, especially in patients with HCV. (Capocaccia R, 2007;Perz, J.F, 2006) …”

Section: Natural History Of Liver Cirrhosis and Its Complicationsmentioning

confidence: 99%

Prognostic Factors for Survival in Patients with Liver Cirrhosis

Samada¹,

Hernández²

2012

Liver Transplantation - Basic Issues

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Hepatocellular Carcinoma: Trends of Incidence and Survival in Europe and the United States at the End of the 20th Century

Cited by 126 publications

References 32 publications

Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: A long-term cohort study

Repeated radiofrequency ablation for management of patients with cirrhosis with small hepatocellular carcinomas: A long-term cohort study

Ultrasound surveillance for early detection of hepatocellular carcinoma among patients with chronic hepatitis C

Prognostic Factors for Survival in Patients with Liver Cirrhosis

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