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Am J Surg. 2015 Jul;210(1):146-52. doi: 10.1016/j.amjsurg.2014.06.036. Epub 2014 Oct 13.

The changing characteristics of hepatocellular cancer in Hawaii over time.

Author information

1
Department of Surgery, John A. Burns School of Medicine, University of Hawaii, 550 South Beretania Street, Suite 403, Honolulu, Hawaii 96813, USA; Transplant Center, Queens Medical Center, Honolulu, HI, USA; Cancer Center, University of Hawaii, Honolulu, HI, USA. Electronic address: hepatoma@aol.com.
2
Department of Surgery, John A. Burns School of Medicine, University of Hawaii, 550 South Beretania Street, Suite 403, Honolulu, Hawaii 96813, USA; Transplant Center, Queens Medical Center, Honolulu, HI, USA.
3
Cancer Center, University of Hawaii, Honolulu, HI, USA.
4
Liver Center, Queens Medical Center, Honolulu, HI, USA.

Abstract

BACKGROUND:

The incidence of hepatocellular cancer (HCC) is increasing, and we sought to characterize the differences and trends in HCC over 2 decades in Hawaii.

METHODS:

This retrospective study of 821 HCC cases analyzed risk factors, diabetes, alpha-fetoprotein (AFP), tumor characteristics, and treatment, comparing 5-year eras (1993 to 2012).

RESULTS:

With succeeding eras, there were fewer Asians, immigrants, and hepatitis B-related HCC. Hepatitis C, diabetes, hyperlipidemia, and body mass index have increased. Over time, more patients had normal AFP, and normal AFP was seen more often in nonviral HCC (49.6% vs 33.2%, P = .007). Over time, the proportion of patients who underwent resection or transplant was stable, but fewer patients underwent no therapy.

CONCLUSIONS:

Characteristics of HCC are changing, and diagnosis may be more difficult as metabolic factors are becoming more important than viral factors. AFP seems to be a less important biomarker, and clearly, better diagnostic tools will be necessary to identify HCC in the future.

KEYWORDS:

Hepatocellular cancer; Liver resection; Liver transplant; Metabolic factors; Viral hepatitis

PMID:
25510478
DOI:
10.1016/j.amjsurg.2014.06.036
[Indexed for MEDLINE]

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