{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T08:37:02Z","timestamp":1762072622831,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Background: We initiated a prospective screening trial in patients with hepatitis to diagnose HCC in the early stage and to evaluate the impact on long-term survival. Methods: From 1993\u20132006, 10,372 patients with chronic hepatitis B (14%), hepatitis C (81%), or both (5%) were enrolled in an HCC screening program. All patients underwent liver biopsy at enrollment. Transabdominal ultrasonography and serum alpha-fetoprotein were evaluated every 6 months. Abnormal screening results led to axial imaging and tumor biopsy. Results: Cirrhosis was confirmed on biopsy in 2074 patients (20%). HCC was diagnosed in 1016 patients (9.8%), all of whom had cirrhosis (49.0% HCC incidence in patients with cirrhosis). HCC was diagnosed at the initial screening in 165 patients (16.2%) and on follow-up in 851 patients (83.8%). The HCC diagnosis median time during follow-up screening was 6 years (range 4\u201310). Curative-intent treatment (resection, ablation, or transplant) was performed in 713 patients (70.2%). Overall survival at 5 and 10 years in those 713 patients was 30% and 4%, respectively, compared to no 5-year survivors in the 303 patients with advanced-stage disease (p &lt; 0.001). Cause of death at 5 years in the 713 patients treated with curative intent was HCC in 371 patients (52%), progressive cirrhosis in 116 patients (16%), and other causes in 14 patients (2%). At 10 years, 456 patients (64%) had died from HCC, 171 (24%) from progressive cirrhosis, and 57 (8%) from other causes. Conclusions: Our screening program diagnosed early-stage HCC, permitting curative-intent treatment in 70%, but the 10-year survival rate is 4% due to HCC recurrence and progressive cirrhosis.<\/jats:p>","DOI":"10.3390\/biology11111597","type":"journal-article","created":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T06:01:28Z","timestamp":1667282488000},"page":"1597","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Long-Term Survival and Curative-Intent Treatment in Hepatitis B or C Virus-Associated Hepatocellular Carcinoma Patients Diagnosed during Screening"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-5408","authenticated-orcid":false,"given":"Francesco","family":"Izzo","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, IRCCS Fondazione \u201cG. Pascale\u201d National Cancer Institute, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meredith C.","family":"Mason","sequence":"additional","affiliation":[{"name":"Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Silberfein","sequence":"additional","affiliation":[{"name":"Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nader N.","family":"Massarweh","sequence":"additional","affiliation":[{"name":"Surgical and Perioperative Care, Atlanta VA Health Care System, Decatur, GA 30033, USA"},{"name":"Division of Surgical Oncology, Department of Surgery, Emory University School of Medicine, Atlanta, GA 30307, USA"},{"name":"Department of Surgery, Morehouse School of Medicine, Atlanta, GA 30310, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cary","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hop S.","family":"Tran Cao","sequence":"additional","affiliation":[{"name":"Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Palaia","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, IRCCS Fondazione \u201cG. Pascale\u201d National Cancer Institute, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Piccirillo","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, IRCCS Fondazione \u201cG. Pascale\u201d National Cancer Institute, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6252-573X","authenticated-orcid":false,"given":"Andrea","family":"Belli","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, IRCCS Fondazione \u201cG. Pascale\u201d National Cancer Institute, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6969-4157","authenticated-orcid":false,"given":"Renato","family":"Patrone","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, IRCCS Fondazione \u201cG. Pascale\u201d National Cancer Institute, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Fusco","sequence":"additional","affiliation":[{"name":"Medical Oncolody Division, Igea SpA, 80013 Naples, Italy"},{"name":"Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, via della Signora 2, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6601-3221","authenticated-orcid":false,"given":"Vincenza","family":"Granata","sequence":"additional","affiliation":[{"name":"Division of Radiology, Istituto Nazionale Tumori IRCCS Fondazione Pascale\u2014IRCCS di Napoli, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven A.","family":"Curley","sequence":"additional","affiliation":[{"name":"Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA"},{"name":"Oncology Institute, Christus Trinity Mother Frances Health System, Tyler, TX 75702, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21654","article-title":"Cancer Statistics","volume":"71","author":"Siegel","year":"2021","journal-title":"CA Cancer J Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1186\/s13027-021-00393-0","article-title":"Diagnostic evaluation and ablation treatments assessment in hepatocellular carcinoma","volume":"16","author":"Granata","year":"2021","journal-title":"Infect. 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Dis."}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/11\/11\/1597\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:07:16Z","timestamp":1760144836000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/11\/11\/1597"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,1]]},"references-count":48,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["biology11111597"],"URL":"https:\/\/doi.org\/10.3390\/biology11111597","relation":{},"ISSN":["2079-7737"],"issn-type":[{"type":"electronic","value":"2079-7737"}],"subject":[],"published":{"date-parts":[[2022,11,1]]}}}