Clinical aspects of hepatocellular carcinoma in Japan

HCC in Japan has very different characteristics from that in other Asian countries. Because, among the Japanese HCC patients approximately 80% of the patients are HCV positive and they are aged over 60 years old. On the other hand, in many Asian countries HBV-positive HCC patients are dominant and their age is younger than the Japanese patients. Early diagnosis of HCC is mainly performed by means of imaging diagnostic technique such as abdominal ultrasonography, dynamic CT, dynamic MRI and CT angiography. If small HCC less than 3 cm in diameter is found and liver function is well preserved, local ablation therapy or surgical treatment promises better than 5 years survival (over 60%). While, TAE or TACE is performed in cases of HCC larger than 3 cm in size, if liver failure is not complicated. In advanced HCC cases with multiple tumors, arterial infusion of anti- cancer drug has been applied. However, its efficacy is not estimated. Chemoprevention is another modality for HCC. Eradication of HCV with an anti-viral agent has proven to prevent hepato-carcinogenesis. As for chemoprevention of HCC, some trials are on going in Japan.