Only Slight Improvement in Hepatocellular Carcinoma Survival

SAN DIEGO—Hepatocellular carcinoma (HCC) is increasing in the United States, while survival rates have not improved substantially, Andrew Mason, MD, of the University of New Mexico Health Sciences Center, Albuquerque, said at the annual meeting of the American Gastroenterological Association (AGA), held during the Digestive Disease Week conference.

Dr. Mason and his colleagues published an article in 1999 that looked at the rise in hepatocellular carcinoma. Their new study looks at survival rates.

“Using the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database, we looked at biopsies confirmed from 1977 to 1996 to see if there was a trend,” Dr. Mason said. “We found 7,389 patients. Of those, 73% were men, which was to be expected.”

The overall median survival for the entire group increased from 0.57 years during 1977 to 1981 to 0.64 years from 1992 to 1996. The overall 1-year survival increased from 14% in the earlier period to 23% in the later period. The 5-year survival rate increased from 2% to 6%.

Dr. Mason noted that survival was similar between men and women, and, in general, there were no significant differences among the various ethnic groups.

He did notice a difference based on treatment. During 1992 to 1996, only 9.1% of hepatocellular carcinoma patients underwent either radical or palliative surgery. This subgroup, he said, had a significantly prolonged survival, compared with those who did not have surgery (median survival, 2.35 years vs 0.60 years).

The 1-year survival rate for those who had surgery was 72%, compared to 18% for those without surgery, and for 5-year survival, the numbers were 42% vs 3%. Similar benefits were seen in the 8.2% of patients who had undergone surgery during 1987 to 1991.

“The heart of the matter is that more people diagnosed in the 1990s are surviving longer, but it ultimately levels out,” he said. “One reason is that there is more early screening. So patients are more likely to be alive in a year, but after 5 years, there’s almost total mortality. Even after 1 year, four of five patients are dead.”

With more aggressive treatment, patients do live a little longer, but, Dr. Mason noted, “with so few people surviving, we’re making no great headway in treatment. Only a very small number of patients are having surgery, but those who do tend to live longer.” ONIn SAN DIEGO—Hepatocellular carcinoma (HCC) is increasing in the United States, while survival rates have not improved substantially, Andrew Mason, MD, of the University of New Mexico Health Sciences Center, Albuquerque, said at the annual meeting of the American Gastroenterological Association (AGA), held during the Digestive Disease Week conference.

Dr. Mason and his colleagues published an article in 1999 that looked at the rise in hepatocellular carcinoma. Their new study looks at survival rates.

“Using the National Cancer Institute’s Surveillance, Epidemiology and End Results (SEER) database, we looked at biopsies confirmed from 1977 to 1996 to see if there was a trend,” Dr. Mason said. “We found 7,389 patients. Of those, 73% were men, which was to be expected.”

The overall median survival for the entire group increased from 0.57 years during 1977 to 1981 to 0.64 years from 1992 to 1996. The overall 1-year survival increased from 14% in the earlier period to 23% in the later period. The 5-year survival rate increased from 2% to 6%.

Dr. Mason noted that survival was similar between men and women, and, in general, there were no significant differences among the various ethnic groups.

He did notice a difference based on treatment. During 1992 to 1996, only 9.1% of hepatocellular carcinoma patients underwent either radical or palliative surgery. This subgroup, he said, had a significantly prolonged survival, compared with those who did not have surgery (median survival, 2.35 years vs 0.60 years).

The 1-year survival rate for those who had surgery was 72%, compared to 18% for those without surgery, and for 5-year survival, the numbers were 42% vs 3%. Similar benefits were seen in the 8.2% of patients who had undergone surgery during 1987 to 1991.

“The heart of the matter is that more people diagnosed in the 1990s are surviving longer, but it ultimately levels out,” he said. “One reason is that there is more early screening. So patients are more likely to be alive in a year, but after 5 years, there’s almost total mortality. Even after 1 year, four of five patients are dead.”

With more aggressive treatment, patients do live a little longer, but, Dr. Mason noted, “with so few people surviving, we’re making no great headway in treatment. Only a very small number of patients are having surgery, but those who do tend to live longer.”