Kwak, Hee-Won; Park, Joong-Won; Nam, Byung-Ho; Yu, Ami; Woo, Sang Myung; Kim, Tae Hyun; Kim, Seong Hoon; Koh, Young Hwan; Kim, Hyun Beom; Park, Sang Jae; Lee, Woo Jin; Hong, Eun Kyung; Kim, Chang-Min
Journal of gastroenterology and hepatology
2014Apr ; 29 ( 4 ) :820-9.
PMID : 24325272
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Kwak, Hee-Won -
Park, Joong-Won -
Nam, Byung-Ho -
Yu, Ami -
Woo, Sang Myung -
Kim, Tae Hyun -
Kim, Seong Hoon -
Koh, Young Hwan -
Kim, Hyun Beom -
Park, Sang Jae -
Lee, Woo Jin -
Hong, Eun Kyung -
Kim, Chang-Min -
ABSTRACT
BACKGROUND AND AIMS: To evaluate the clinical outcomes of patients with hepatocellular carcinoma (HCC) and compare the findings with that of a previous cohort.
METHODS: Overall, 1972 HCC patients diagnosed and treated at the National Cancer Center, Korea between 2004 and 2009 were enrolled. The data of this cohort were compared with those of a previous cohort (2000-2003) from the same institution.
RESULTS: In all (mean age, 56.4 years; 1642 men), 74.6% was hepatitis B virus (HBV) positive, 81.6% were Child-Pugh (CP) class A, and 64.4% was Barcelona Clinic Liver Cancer (BCLC) stage C. The modified Union for International Cancer Control (mUICC) stage I, II, III, IVa, and IVb was found in 8.9%, 29.6%, 24.8%, 23.1%, and 13.6% patients, respectively. The most common initial treatment was transarterial chemotherapy (58.3%), followed by resection (18.6%). The 5-year survival rate of BCLC stage 0, A, B, and C were 79.6%, 67.2%, 33.9%, and 17.1%, respectively. The performance status, BCLC stage, mUICC stage, CP class, model for end-stage liver disease score, tumor characteristics, portal vein tumor invasion, and serum alpha-fetoprotein level proved to be independent prognostic variables. Overall survival in the present cohort was better than that in the previous cohort (hazard ratio, 0.829; 95% confidence interval, 0.754-0.912), especially for advanced HCC patients with HBV-positive status.
CONCLUSIONS: This cohort study provides valuable insights into the characteristics of HCC in Korean patients. Our findings may help develop clinical trials, treatment strategies, and prognosis systems for HCC patients in HBV-endemic areas. CI - ??2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
keyword
HBV-endemic area; cohort; hepatocellular carcinoma; survival outcome; temporal comparison
MESH
Biomarkers, Tumor/blood, Carcinoma, Hepatocellular/diagnosis/*mortality/pathology/*therapy, Cohort Studies, Female, Hepatitis B/*epidemiology, Humans, Korea/epidemiology, Liver Neoplasms/diagnosis/*mortality/pathology/*therapy, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Prognosis, Survival, Time Factors, alpha-Fetoproteins/analysis
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