Characterization and Detection Strategy Exploration in Cryptogenic Hepatocellular Carcinoma: Insights From a Super‐Aged Region in Japan
ABSTRACT Background and Aim In recent years, there has been a rise in cryptogenic hepatocellular carcinoma (c‐HCC) cases in Japan, posing a detection challenge due to an unknown etiology. This study aims to enhance diagnostic strategies for c‐HCC by analyzing its characteristics and exploring curren...
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Wiley
2025-01-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.70490 |
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| author | Takaaki Sugihara Takakazu Nagahara Takuya Kihara Suguru Ikeda Yoshiki Hoshino Yukako Matsuki Takuki Sakaguchi Hiroki Kurumi Takumi Onoyama Tomoaki Takata Tomomitsu Matono Hajime Isomoto |
| author_facet | Takaaki Sugihara Takakazu Nagahara Takuya Kihara Suguru Ikeda Yoshiki Hoshino Yukako Matsuki Takuki Sakaguchi Hiroki Kurumi Takumi Onoyama Tomoaki Takata Tomomitsu Matono Hajime Isomoto |
| author_sort | Takaaki Sugihara |
| collection | DOAJ |
| description | ABSTRACT Background and Aim In recent years, there has been a rise in cryptogenic hepatocellular carcinoma (c‐HCC) cases in Japan, posing a detection challenge due to an unknown etiology. This study aims to enhance diagnostic strategies for c‐HCC by analyzing its characteristics and exploring current opportunities for detection. Methods A retrospective study was conducted from April 2012 to March 2022, enrolling 372 newly diagnosed hepatocellular carcinoma (HCC) patients. Excluding cases associated with hepatitis viral infection, alcoholic liver disease, non‐alcoholic fatty liver disease/steatohepatitis, autoimmune hepatitis, primary biliary cholangitis, and congestive hepatopathy, the study specifically focused on genuine c‐HCC. The analysis delved into the characteristics, detection opportunities, and survival outcomes associated with c‐HCC. Results Among the non‐viral HCC cases, 55 patients (29.3%) (34 men and 21 women) were diagnosed with c‐HCC, making it the second‐highest etiology. Notably, individuals with c‐HCC, typically aged 60 and above (median age 76.0), exhibited a women predominance and presented with larger tumors (4.5 cm vs. 2.5 cm), correlating with a poorer prognosis. Cirrhosis was notably absent in most c‐HCC cases (72.7%), and more than half (56.4%) did not have diabetes mellitus (DM). Diagnostic pathways for c‐HCC primarily involved incidental imaging (47%) and symptoms (24%). Within the cohort of c‐HCC, the prognosis for symptomatic cases is notably unfavorable compared to other cases [median survival time 19.0 (7.0–45.0) months vs. 47.0 (29.0–76.0) months, p = 0.029]. In the multivariate regression analysis, age and women emerged as independent factors associated with c‐HCC. Rather than a significant increase in women, there is a narrowing gender gap. Conclusion Patients with c‐HCC were predominantly elderly, without cirrhosis or diabetes, and exhibited minimal gender differences. Detection often occurred incidentally through abdominal imaging. Considering the limitations of conventional surveillance, it seems reasonable to propose that abdominal imaging be included in cancer screening, particularly for individuals aged 60 and older. Trial Registration 1610A127 |
| format | Article |
| id | doaj-art-adb2c047de9a4d49b9a246f1a7022a6a |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | Cancer Medicine |
| spelling | doaj-art-adb2c047de9a4d49b9a246f1a7022a6a2025-01-24T08:46:08ZengWileyCancer Medicine2045-76342025-01-01142n/an/a10.1002/cam4.70490Characterization and Detection Strategy Exploration in Cryptogenic Hepatocellular Carcinoma: Insights From a Super‐Aged Region in JapanTakaaki Sugihara0Takakazu Nagahara1Takuya Kihara2Suguru Ikeda3Yoshiki Hoshino4Yukako Matsuki5Takuki Sakaguchi6Hiroki Kurumi7Takumi Onoyama8Tomoaki Takata9Tomomitsu Matono10Hajime Isomoto11Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanDivision of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanDivision of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanDivision of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanDivision of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanDivision of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanDivision of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanDivision of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanDivision of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanDivision of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanDepartment of Gastroenterology Hyogo Prefectural Harima‐Himeji General Medical Center Himeji JapanDivision of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine Tottori University Yonago JapanABSTRACT Background and Aim In recent years, there has been a rise in cryptogenic hepatocellular carcinoma (c‐HCC) cases in Japan, posing a detection challenge due to an unknown etiology. This study aims to enhance diagnostic strategies for c‐HCC by analyzing its characteristics and exploring current opportunities for detection. Methods A retrospective study was conducted from April 2012 to March 2022, enrolling 372 newly diagnosed hepatocellular carcinoma (HCC) patients. Excluding cases associated with hepatitis viral infection, alcoholic liver disease, non‐alcoholic fatty liver disease/steatohepatitis, autoimmune hepatitis, primary biliary cholangitis, and congestive hepatopathy, the study specifically focused on genuine c‐HCC. The analysis delved into the characteristics, detection opportunities, and survival outcomes associated with c‐HCC. Results Among the non‐viral HCC cases, 55 patients (29.3%) (34 men and 21 women) were diagnosed with c‐HCC, making it the second‐highest etiology. Notably, individuals with c‐HCC, typically aged 60 and above (median age 76.0), exhibited a women predominance and presented with larger tumors (4.5 cm vs. 2.5 cm), correlating with a poorer prognosis. Cirrhosis was notably absent in most c‐HCC cases (72.7%), and more than half (56.4%) did not have diabetes mellitus (DM). Diagnostic pathways for c‐HCC primarily involved incidental imaging (47%) and symptoms (24%). Within the cohort of c‐HCC, the prognosis for symptomatic cases is notably unfavorable compared to other cases [median survival time 19.0 (7.0–45.0) months vs. 47.0 (29.0–76.0) months, p = 0.029]. In the multivariate regression analysis, age and women emerged as independent factors associated with c‐HCC. Rather than a significant increase in women, there is a narrowing gender gap. Conclusion Patients with c‐HCC were predominantly elderly, without cirrhosis or diabetes, and exhibited minimal gender differences. Detection often occurred incidentally through abdominal imaging. Considering the limitations of conventional surveillance, it seems reasonable to propose that abdominal imaging be included in cancer screening, particularly for individuals aged 60 and older. Trial Registration 1610A127https://doi.org/10.1002/cam4.70490cryptogenicepidemiologyhepatocellular carcinomasurveillance |
| spellingShingle | Takaaki Sugihara Takakazu Nagahara Takuya Kihara Suguru Ikeda Yoshiki Hoshino Yukako Matsuki Takuki Sakaguchi Hiroki Kurumi Takumi Onoyama Tomoaki Takata Tomomitsu Matono Hajime Isomoto Characterization and Detection Strategy Exploration in Cryptogenic Hepatocellular Carcinoma: Insights From a Super‐Aged Region in Japan Cancer Medicine cryptogenic epidemiology hepatocellular carcinoma surveillance |
| title | Characterization and Detection Strategy Exploration in Cryptogenic Hepatocellular Carcinoma: Insights From a Super‐Aged Region in Japan |
| title_full | Characterization and Detection Strategy Exploration in Cryptogenic Hepatocellular Carcinoma: Insights From a Super‐Aged Region in Japan |
| title_fullStr | Characterization and Detection Strategy Exploration in Cryptogenic Hepatocellular Carcinoma: Insights From a Super‐Aged Region in Japan |
| title_full_unstemmed | Characterization and Detection Strategy Exploration in Cryptogenic Hepatocellular Carcinoma: Insights From a Super‐Aged Region in Japan |
| title_short | Characterization and Detection Strategy Exploration in Cryptogenic Hepatocellular Carcinoma: Insights From a Super‐Aged Region in Japan |
| title_sort | characterization and detection strategy exploration in cryptogenic hepatocellular carcinoma insights from a super aged region in japan |
| topic | cryptogenic epidemiology hepatocellular carcinoma surveillance |
| url | https://doi.org/10.1002/cam4.70490 |
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