This study indicates continuing improvement in stage distribution, treatment, and survival for HCC cases in the SEER-13 registries. In the late 1970s, 5-year cause-specific HCC survival was 3%. Three decades later, HCC is increasingly detected at early stages when it is potentially curable.5 These improvements may be, in part, attributable to clinical surveillance of individuals with known risk factors for HCC.15 Despite the encouraging findings, overall 5-year survival remains less than 20%, and a majority of cases received neither surgical nor ablative therapy. Taken together, the findings suggest that further improvements in HCC prognosis may be possible. Potential may exist to improve survival

through clinical management guidelines.5 NVP-BKM120 in vitro The best 5-year survival in this report was observed among cases that received liver transplantation (84%). Furthermore, RFA was potentially curative among cases with early stage HCC,16 associated with a 53% 5-year survival similar to that of cases with reported resection (47%).4 Goals to improve overall cancer survival17 may be advanced by following patients at-risk for HCC to enable early stage diagnosis and use of potentially curative therapy.15 In the present report, Asian or Pacific Islander HCC cases had

better 5-year survival than white, Hispanic, and black cases. this website Other reports also describe differences in overall HCC survival18, 19 and treatment-specific survival between racial groups.20 In one study of localized-stage cases that received invasive therapy, selleck chemical compared to whites,21 blacks had a 12% higher mortality rate, whereas Asians or Pacific Islanders had a 16% lower mortality rate. The survival advantage among Asians or Pacific Islanders undergoing resection, compared to Hispanics and whites, could be explained by differences in risk factors or HCC-prevention

awareness between these racial groups. For example, a common risk factor for HCC among Asians or Pacific Islanders is chronic hepatitis B virus (HBV) infection.18 Though HBV DNA integrates into the host genome and is thought to be able to induce HCC without cirrhosis, hepatitis C virus (HCV) is an RNA virus that does not integrate into the host genome, with carcinogenesis mainly attributed to chronic inflammation and fibrosis.22 In a recent study of early stage HCC, compared to cases with HCV-associated HCC, HBV-associated HCC cases had better outcomes after resection.22 This finding was attributed to better liver reserve and less hepatic inflammation among the HBV-associated cases. Furthermore, because some Asian or Pacific Islander groups are known to be at high risk of HCC because of endemic HBV infection in parts of Asia, screening programs within affected communities that facilitate the detection of HCC at earlier stages.18 Other risk factors and comorbidities might also affect survival across groups.