Temporal improvement in survival of patients with hepatocellular carcinoma in a hepatitis B virus-endemic population
- Authors
- Kim, Bo Hyun; Lim, Young-Suk; Kim, Eun-Yang; Kong, Hyun-Joo; Won, Young-Joo; Han, Seungbong; Park, Sohee; Hwang, Jae Seok
- Issue Date
- Feb-2018
- Publisher
- WILEY
- Keywords
- hepatitis B virus; hepatitis C virus; hepatocellular carcinoma; population; registry
- Citation
- JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, v.33, no.2, pp.475 - 483
- Journal Title
- JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY
- Volume
- 33
- Number
- 2
- Start Page
- 475
- End Page
- 483
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/4068
- DOI
- 10.1111/jgh.13848
- ISSN
- 0815-9319
- Abstract
- Background and Aim: Over the past decade, the management of hepatocellular carcinoma (HCC) and viral hepatitis has been improved. We explored survival trends and factors affecting survival of HCC in a hepatitis B virus (HBV)-endemic population. Methods: From 31521 and 38167 HCC registrants to the population-based national cancer registry in Korea, an HBV-endemic country, in the period of 2003-2005 and 2008-2010, we randomly sampled cohorts of 4515 and 4582 patients, respectively, for the investigation of clinical characteristics and survival. Results: Compared with Cohort 2003-2005, Cohort 2008-2010 had significantly better liver function (Child-Turcotte-Pugh class A, 64.2% vs 71.6%; P < 0.001) and had more advanced tumor stages (Barcelona Clinic Liver Cancer stage B-D, 45.8% vs 50.4%; P < 0.001). HBV was the predominant cause of HCC in both cohorts (62.5% vs 62.2%; P = 0.70). Cohort 2008-2010 had significantly better overall survival than Cohort 2003-2005 by age-adjusted univariate, multivariable, and propensity score-matched analyses (median survival time, 17.2 vs 28.4 months; P < 0.001). In a subcohort analysis, a consistently significant inter-cohort improvement in survival was observed only in patients with HBV-related HCC (median survival, 16.1 vs 30.4 months; P < 0.001). The annual number of patients with HCC receiving oral antiviral agents for HBV precipitously increased from 93 in 2005 to 28520 in 2010 in the country. Conclusions: The consistent improvement in survival of patients with HCC was confined to HBV-related HCC subcohort over the last decade in an HBV-endemic population. The survival improvement coincided with the exponential use of oral antiviral agents for HBV in the patients.
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