Subclinical hepatocellular carcinoma in Hong Kong Chinese

Abstract

Of the 208 Chinese patients with histologically proven hepatocellular carcinoma (HCC) seen during a 5-year period, 191 patients presented with symptomatic HCC and 17 patients with asymptomatic HCC (subclinical HCC, SCHCC) being picked up by α-fetoprotein (AFP) screening. Compared with the patients with symptomatic HCC, patients with SCHCC had a better performance status (p < 0.01), higher serum albumin levels (p < 0.05) and lower alkaline phosphatase levels (p < 0.01). In those patients with symptomatic HCC, 4.7% were operable and only 2 patients had a tumour diameter of less than 5 cm. In contrast, patients with SCHCC had a higher operability rate (76.5%, p < 0.0001) and all had a tumour of less than 5 cm in diameter (p < 0.0001). Patients with SCHCC, most of whom had their tumour resected, had a better long-term survival (p < 0.0001). We conclude that patients with SCHCC picked up by AFP serosurveillance have a better performance status, higher operability and better prognosis.