Epidemiology of hepatocellular carcinoma in Finistère Prospective study from June 2002 to May 2003

Quality of life as a prognostic factor of overall survival in patients with advanced hepatocellular carcinoma: results from two French clinical trials

“…Even though between 60% and 75% of all patients in France are treated in this setting [58], the patients in this study formed a rather homogeneous sample that was not representative of the whole HCC population. Therefore, the conclusions are limited to this specific population and cannot be extended to less advanced patients.…”

Early Detection, Curative Treatment, and Survival Rates for Hepatocellular Carcinoma Surveillance in Patients with Cirrhosis: A Meta-analysis

“…Thirty-eight studies, with a total of 10,904 patients, included data on tumor stage stratified by receipt of HCC surveillance [17],[18],[20],[21],[23]–[26],[28],[29],[31]–[50],[52]–[55],[57],[59],[61],[63]. Twenty-four studies defined early stage using BCLC or Milan criteria [17],[18],[24],[29],[32]–[35],[37],[38],[41]–[45],[47]–[49],[52],[53],[55],[57],[61],[63], whereas six studies used other staging systems (e.g., tumor node metastases [TNM]) [23],[31],[39],[46],[54],[59], and eight used operational definitions (e.g., unifocal lesion less than 3 cm) [20],[21],[25],[26],[28],[36],[40],[50] (Table 1).…”

“…Twenty-four studies defined early stage using BCLC or Milan criteria [17],[18],[24],[29],[32]–[35],[37],[38],[41]–[45],[47]–[49],[52],[53],[55],[57],[61],[63], whereas six studies used other staging systems (e.g., tumor node metastases [TNM]) [23],[31],[39],[46],[54],[59], and eight used operational definitions (e.g., unifocal lesion less than 3 cm) [20],[21],[25],[26],[28],[36],[40],[50] (Table 1). The 24 studies using BCLC or Milan criteria included a total of 6,573 patients, of whom 2,815 (44.1%) were diagnosed by surveillance.…”

“…Rates of curative therapy receipt were consistent across study design (OR 2.18 [95% CI 1.94–2.45] among retrospective studies [17],[19],[20],[26],[28]–[30],[32]–[36],[38],[43],[44],[46],[47],[49],[50],[51],[53]–[55],[58]–[63] versus 2.37 [95% CI 1.51–3.72] among prospective studies [21],[22],[31],[37],[40]), study period (OR 2.12 [95% CI 1.25–3.61] among studies assessing surveillance prior to 1990 [26],[44],[50],[54] versus 2.23 [95% CI 1.87–2.67] among studies assessing surveillance in the 1990s [17],[19],[20], versus 2.13 [95% CI 1.85–2.44] among studies assessing surveillance after 2000 [21],[32],[34],[35],[37],[38],[43],[46],[47],[58],[61],[63]), and type of surveillance tests (OR 2.23 [95% CI 1.83–2.71] with ultrasound alone [20],[28],[32],[38],[46],[47],[61],[62] versus 2.19 [95% CI 1.89–2.53] with ultrasound and/or AFP [17],[19],[22],[26],[29]–[31],[34]–…”

“…Finally, there was no significant difference in the strength of association between HCC surveillance and curative therapy receipt by study location ( p  = 0.20); patients detected by surveillance were significantly more likely to receive curative therapy in both subgroups. The pooled odds of curative therapy were 1.87 (95% CI 1.51–2.31) for studies conducted in Europe [19],[21],[26],[28],[30],[36],[37],[40],[55],[63], 2.19 (95% CI 1.84–2.61) for studies conducted in Asia [17],[22],[31],[34],[38],[49],[50],[51],[54],[58],[62], and 2.52 (95% CI 1.99–3.20) for studies conducted in the United States [32],[33],[35],[43],[44],[46],[47],[53],[59],[61].…”