Subclinical hepatocellular carcinoma: An analysis of 391 patients

✍ Scribed by Dr. Zhao-You Tang; Ye-Qin Yu; Xin-Da Zhou; Bing-Hui Yang; Zeng-Chaen Ma; Zhi-Ying Lin

• Publisher: John Wiley and Sons
• Year: 1993
• Tongue: English
• Weight: 342 KB
• Volume: 53
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/jso.2930530516

✦ Synopsis

Subclinical hepatocellular carcinoma (SCHCC) is defined as HCC without obvious HCC symptoms and signs. During 1958During -1991, 391 , 391 patients with SCHCC were analyzed. In the entire series, 1) 67.3% was detected by natural population screening using alpha-fetoprotein (AFP) serosurvey , while the others were discovered by high-risk population screening or regular health checkup using AFP and/or ultrasonography (US); 2) AFP > 20 pg/L was found in 77.6% of patients; 3) serum hepatitis B surface antigen (HBsAg) was positive in 68.9%; 4) associated liver cirrhosis occurred in 89.1%; 5) the median tumor size was 5 cm, and small HCC ( S 5 cm) amounted to 61.1%; 6) resection was done in 8 1.4%, and limited resection was performed in the majority (71.3%); 7) re-resection for subclinical recurrence was done in 44 patients; and 8) cytoreduction and sequential resection was carried out in 13 patients with unresectable SCHCC. Comparison between SCHCC and clinical HCC (n = 1,251) revealed higher resectability (81.4% vs. 46.8%), lower operative mortality (1.9% vs. 6.0%), and higher 5-year survival (entire series: 50.7% vs. 20.6%; resection: 60.5% vs. 36.8%). It is concluded that the study of SCHCC has resulted in marked improvement of ultimate outcome of HCC; screening in high-risk populations using AFP and/or US, limited resection, and re-resection for subclinical recurrence are some of the key features.