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KMID : 1039320140140020097
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Journal of Liver Cancer
2014 Volume.14 No. 2 p.97 ~ p.107
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Characteristics and Survival of Korean Patients with Hepatocellular Carcinoma: A Nationwide Random Sample Study
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Lim Young-Suk
Sinn Dong-Hyun
Kim Seong-Hyung
Hwang Jae-Seok
Han Kwang-Hyub
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Abstract
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Background/Aims: Given the high incidence and mortality rate of hepatocellular carcinoma (HCC), ensuring high quality of registry data is important for the improvement of health service. Registries by voluntary reporting often lack case completeness and may cause selection bias. A statutory Korean Central Cancer Registry (KCCR) has case completeness and provides accurate information on HCC incidence, but provides limited information about HCC characteristics.
Methods: The Korean Liver Cancer Study Group (KLCSG) and the KCCR jointly built a nationwide cohort of patients who were diagnosed with HCC between 2003 and 2005. Out of 31,521 new HCC cases that were registered at the KCCR between 2003 and 2005, 4,630 cases (14.7% of total HCC cases) were randomly selected and abstracted from 32 hospitals nationwide, and followed up until December 2011. After excluding 110 patients who met the exclusion criteria, a total of 4,520 HCC patients were analyzed.
Results: Mean age at the diagnosis of HCC was 57.1±10.8 years, and males comprised 81.0%. Hepatitis B was the predominant etiology (72%), and hepatitis C comprised 12%. Stage at diagnosis was 10%, 43%, 28%, 11% and 8% for modified International Union Against Cancer (mUICC) stages I, II, III, IV-A and IV-B, respectively. Initial treatment modalities were transarterial therapy in 53%, surgical resection in 10%, local ablation in 7%, and liver transplantation in 1%. The median survival was 1.4 years, and the 1-, 3-, and 5-year survival rates were 56%, 35% and 27%, respectively. Age, gender, Child-Pugh class, etiology, tumor stage at diagnosis, and treatment modality were factors independently related to survival.
Conclusions: About half of HCC patients are diagnosed at advanced stages in Korea. Curativeintent treatments are rarely applied to patients. This data provides unbiased information about the characteristics and outcome of HCC patients in Korea.
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KEYWORD
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Hepatocellular carcinoma, Korea, Survival, Prognostic factor
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