Evolution of prognostic factors in hepatocellular carcinoma in Japan

[Guest guest]

http://www3.interscience.wiley.com/journal/122659682/abstract

Alimentary Pharmacology & Therapeutics

Volume 31 Issue 3, Pages 407 - 414

Published Online: 22 Oct 2009

2006 The Authors Journal compilation 2006 Blackwell Publishing Ltd

Evolution of prognostic factors in hepatocellular carcinoma in Japan

K. NOUSO*,†, Y. KOBAYASHI†, S. NAKAMURA†, S. KOBAYASHI†, J. TOSHIMORI†, K.

KUWAKI†, H. HAGIHARA†, H. ONISHI†, Y. MIYAKE*,†, F. IKEDA*,†, H. SHIRAHA†, A.

TAKAKI†, Y. IWASAKI†, H. KOBASHI† & K. YAMAMOTO†

*Department of Molecular Hepatology ; †Department of Gastroenterology and

Hepatology, Okayama University Graduate School of Medicine, Dentistry, and

Pharmaceutical Sciences, Okayama, Japan

Correspondence to Dr K. Nouso, Department of Molecular Hepatology, Okayama

University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences,

2-5-1 Shikata-cho, Okayama-city, Okayama, 700-8558 Japan.

E-mail: nouso@...

Copyright Journal compilation © 2010 Blackwell Publishing Ltd

Aliment Pharmacol Ther 31, 407–414

ABSTRACT

Background

The surveillance of hepatocellular carcinoma (HCC) has become prevalent, and the

modalities for its treatment have improved.

Aim

To understand the changes that occur in the characteristics and prognostic

factors of HCC with time.

Methods

Newly diagnosed HCC patients were divided into two groups; patients treated

before 31 December 2000 (n = 504), and after 1 January 2001 (n = 746), and their

clinical backgrounds and prognostic factors were analysed.

Results

The number of patients negative for both Hepatitis B surface antigen (HBsAg) and

Hepatitis C virus antibody (HCVAb) increased with time (NBNC-HCC). The size of

HCC decreased in patients who were positive for HBsAg (B-HCC) or HCVAb (C-HCC),

whereas no difference was observed in NBNC-HCC. The patient survival of C-HCC

improved; however, no difference was detected for NBNC-HCC. In multivariate

analysis, low albumin, high aspartate aminotransferase (AST), ascites, large

tumour size, multiple tumour number and high alpha-fetoprotein were risk factors

for survival before 2000, whereas the presence of HBsAg was additionally

selected as a good prognostic factor and AST was excluded after 2001.

Conclusions

The prognostic factors as well as clinical background of HCC changed with time,

and the presence of HBsAg was found to be an additional good prognostic factor

after 2001.

--------------------------------------------------------------------------------

Publication data Submitted 26 August 2009 First decision 15 September 2009

Resubmitted 16 October 2009 Accepted 19 October 2009 Epub Accepted Article 22

October 2009

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1365-2036.2009.04179