Reply to the letter by Huo et al. regarding our manuscript “The transition in the etiologies of hepatocellular carcinoma-complicated liver cirrhosis in a nationwide survey of Japan”

Excerpt

We thank Huo et al. for their interest in our research [1]. In Japan, national measurements for anti-hepatitis viruses have been conducted with a large budget [2], and the causes of liver cirrhosis have remarkably changed over the past decade [3]. Our nationwide survey showed that a decrease in viral hepatitis-related HCC was responsible for the etiological changes in hepatocellular carcinoma (HCC)-complicated liver cirrhosis in Japan [1]. As described in the discussion section of the paper [1], our survey focused on the etiological transition, and the collected data were limited to the number of cases per institution. Therefore, we cannot provide more detailed information, such as the stages of HCC or prognosis, of our cohort. However, better control of the hepatitis virus can reduce the risk of developing liver failure and allow cirrhotic patients to receive intensive treatment, suggesting that the prognosis of HCC patients has improved in Japan. As reported from Taiwan [4] and Italy [5], data concerning changes in the HCC stage and prognosis are clinically important and useful. We plan to collect data from participating institutions and analyze them in a future study. Thank you for your valuable comments. …