From 1992 to 2008, the incidence rate of histologically unconfirmed HCC increased 2.5 times more rapidly than the incidence rate of confirmed HCC (Fig. 1). The APC in incidence rates for these two groups Saracatinib research buy were 7.9 and 3.2, respectively (both statistically significant: P < 0.05). Between 1992 and 2008, incidence rates of localized stage HCC increased

nearly twice as rapidly as rates of regional and distant stage HCC combined (Fig. 2) and surpassed regional and distant stage incidence rates during 2006-2008. The APC in incidence rates for the two groups were 8.1 and 4.2, respectively (both statistically significant: P < 0.05, as were APCs for regional and distant stage alone, data not shown). The APC for unstaged HCC was −2.6 (P < 0.05). Incidence rates of reported invasive liver surgery or ablation (Fig. 3) increased significantly from 1992 to 2008 (APC = 10.7; P < 0.05). Incidence rates of HCC receiving no surgical intervention also increased significantly from 1992 to 2008 (APC = 7.2; P < 0.05). During 1998-2008, most HCC cases with reported first-course surgery or ablation had localized stage HCC (Fig. 4), including cases receiving transplantation (77%), resection (75%), and local tumor destruction (70%). Overall, 41% of cases had localized-stage HCC. One third of cases with no reported surgery or local tumor

destruction had localized-stage HCC. Among HCC cases diagnosed during 1998-2007 and followed for vital status through 2008, transplant recipients experienced 84% 5-year survival (Fig. 5). Cases with Nutlin-3a mw local tumors less than 3 cm that received RFA had 5-year survival of 53%, whereas cases undergoing liver resection had 5-year survival of 47%. Among cases with reported local tumor destruction, 5-year survival was 35%. Compared to the 3% 5-year cause-specific survival in SEER-9 during 1975-1977 (data not shown), overall HCC survival during 1998-2007 was

18%, whereas survival was 8% among cases without reported invasive surgery or local tumor destruction. 5-year survival exceeded 75% among transplant recipients in all non-Hispanic racial and Hispanic ethnic groups with informative data (Fig. 5). Results were suppressed when there were fewer than 16 cases. selleckchem Among cases with reported liver resection, Asians or Pacific Islanders experienced significantly better 5-year survival (52%) than Hispanics (35%) and blacks (33%). American Indian/Alaska Native cases had 63% survival after resection, with wide CIs. 5-year survival after local tumor destruction was significantly higher among Asians or Pacific Islanders (43%) than black (21%) cases. Overall 5-year cause-specific survival among Asians or Pacific Islanders (23%) was significantly better than among white (18%), Hispanic (15%), or black cases (12%). White cases (18%) and American Indian/Alaska Native cases (20%) had significantly better survival than black cases (12%).