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AIM To compare patients who underwent resection of early stage hepatocellular cancer(HCC) in three different countries. METHODS This retrospective study characterizes 573 stage Ⅰ/Ⅱ HCC patients treated with liver resection in 3 tertiaryreferral centers: Tokyo(n = 250), Honolulu(n = 146) and Shanghai(n = 177).RESULTS Shanghai patients were younger, predominantly male, hepatitis-B seropositive(94%) and cirrhotic(93%). Tokyo patients were older and more likely to have hepatitis-C(67%), smaller tumors, low albumin, and normal alpha-fetoprotein. The Honolulu cohort had the largest tumors and 30% had no viral hepatitis. Ageadjusted mortality at 1 and 5-years were lower in theTokyo cohort compared to Honolulu and there was no difference in mortality between Shanghai and Honolulu cohorts. Elevated alpha-fetoprotein, low albumin and tumor > 5 cm were associated with increased 1-year mortality. These factors and cirrhosis were independently associated with increased 5-year mortality. Independent risk factors of survival varied when examined separately by center. CONCLUSION The profile of early-stage HCC patients is strikingly different across countries and likely contributes to survival differences. Underlying differences in patient populations including risk factors/comorbidities influencing disease progression may also account for variation in outcomes.
METHODS This retrospective study characterizes 573 stage I / II HCC patients treated with liver resection in tertiary tertiary centers: Tokyo (n = 250), Honolulu (HCC) Tokyo patients were older and more likely to have hepatitis-C (67%) and Shanghai (n = 177) .RESULTS Shanghai patients were younger, predominantly male, hepatitis-B seropositive %), smaller tumors, low albumin, and normal alpha-fetoprotein. The Honolulu cohort had the largest tumors and 30% had no viral hepatitis. Ageadjusted mortality at 1 and 5-years were lower in theTokyo cohort compared to Honolulu and there was no Difference in mortality between Shanghai and Honolulu cohorts. Elevated alpha-fetoprotein, low albumin and tumor> 5 cm were associated with increased 1-year mortality. These factors and cirrhosis were independently associated with increased 5-year mortality. dent risk factors of survival diversity when patient separately including center. CONCLUSION The profile of early-stage HCC patients is strikingly different across countries and likely contributes to survival differences. Underlying differences in patient populations including risk factors / comorbidities influencing disease progression may also account for variation in outcomes.