ABSTRACT
OBJECTIVE: Surveillance of cirrhotic patients enables early detection of hepatocellular carcinoma (HCC) and possibly prolongs survival. The aim of this study was to explore whether early-stage HCC can be detected earlier at a specialized department of liver disease than in other institutions. METHODS: The study subjects were 574 patients with HCC. Patients were subdivided into 3 groups according to the manner of HCC detection: group A, HCC was detected in 91 patients during periodic examination at Kurume University School of Medicine; group B, HCC was detected in 301 patients during periodic examination at other institutions; group C, HCC was detected incidentally or because of symptoms in 182 patients. RESULTS: The HCC detected in group A was significantly of smaller size (20.4 mm) compared with groups B (27.1 mm, P<0.0001) and C (57.8 mm, P<0.0001). The frequency of receiving treatment (surgery or local ablation therapy) was significantly higher in group A (73%) than in groups B (52%, P=0.002) and C (26%, P<0.0001). The 5-year survival rates were 52% for group A, 40% for group B, and 23% for group C, respectively. The survival of group A was significantly better than that of groups B (P=0.0157) and C (P<0.0001). CONCLUSIONS: Surveillance for HCC at specialized Department of Liver Disease can detect early-stage HCC, resulting in a higher chance of receiving promising treatment.
Subject(s)
Carcinoma, Hepatocellular/diagnosis , Hospital Departments , Liver Neoplasms/diagnosis , Population Surveillance , Aged , Bilirubin/blood , Biomarkers/blood , Biomarkers, Tumor/blood , Carcinoma, Hepatocellular/etiology , Carcinoma, Hepatocellular/mortality , Carcinoma, Hepatocellular/therapy , Early Diagnosis , Female , Follow-Up Studies , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/epidemiology , Hepatitis B, Chronic/therapy , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/epidemiology , Hepatitis C, Chronic/therapy , Humans , Japan/epidemiology , Liver Cirrhosis/complications , Liver Cirrhosis/epidemiology , Liver Cirrhosis/therapy , Liver Diseases, Alcoholic/complications , Liver Diseases, Alcoholic/epidemiology , Liver Diseases, Alcoholic/therapy , Liver Neoplasms/etiology , Liver Neoplasms/mortality , Liver Neoplasms/therapy , Male , Middle Aged , Neoplasm Staging , Protein Precursors/blood , Prothrombin , Serum Albumin/metabolism , Survival Rate , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Ultrasonography, Interventional , alpha-Fetoproteins/metabolismABSTRACT
Loss of appetite is frequently seen and is a main factor affecting quality of life (QOL) in patients with advanced cancer. The etiology for loss of appetite in patients with cancer is multifactorial. The sensory properties of food are factors regulating appetite. Changes in taste, smell and texture of foods influence food intake. The appearance of the food is also a notable factor in sensory-specific satiety. We described a 46-year-old Japanese woman with multiple metastatic liver tumors. Although there was no obvious factor for loss of appetite, she suffered from a loss of appetite and subsequent malnutrition. In order to improve the appearance of food, we reduced the diet to 1,000 kcal/day from 1,500 kcal/day. On the new diet, the patient's appetite significantly increased and patient's nutritional status was improved. Eating whole diet was an important achievement and increased in mental aspects of QOL. Arrangement for the appearance of food may be a simple and nontoxic therapeutic strategy for patients with cancer suffering a loss of appetite.
