Changes in Clinical Characteristics and Outcome of Patients with Hepatocellular Carcinoma (HCC) in a 16-Year Cohort = Changes in Clinical Characteristics and Outcome of Patients with Hepatocellular Carcinoma (HCC) in a 16-Year Cohort

다국어 초록 (Multilingual Abstract)

Aims: In South Korea, an endemic area of hepatitis B virus (HBV), the incidence and mortality of HCC is gradually decreasing by HBV vaccination, antiviral treatment, early tumor detection, improved treatment options, and evidence-based guidelines. This study investigated the changes over time in the baseline characteristics and clinical outcomes of HCC patients at a single center.
Methods: Patients initially diagnosed with and treated for HCC at the National Cancer Center between 2000 and 2015 (n=4291) were followed-up until February 2017. Difference in patient characteristics and outcomes were compared in patients diagnosed in 2000-2004 (n=1157), 2005-2009 (n=1678), and 2010-2015 (n=1456).
Results: The median age of the patient cohort was 57 years (range 13-98) years, and most were male (3502, 81.6%). HBV infection was the most common etiology (74.7%). The percentage of patients with Child class A (69.1%, 79.9%, and 87.1%, respectively) and BCLC stage 0 (4.1%, 5.2%, and 9.8%, respectively) increased significantly over time. Median overall survival also increased significantly over time, from 14.4 months (95% confidence interval [CI] 12.0-16.8 months) in 2000-2004, to 22.9 months (95% CI, 20.3-25.5 months) in 2005-2009, to 53.6 months (95% CI, 45.7- 61.5 months) in 2010-2015 (p<0.001). OS of patients with modified UICC stage IV (3.6 vs. 4.7 vs 6.1 months, p<0.001) and with HBV etiology (12.7 vs 20.4 vs 64.5 months, p<0.001) was observed in patients diagnosed in 2000-2004, 2005-2009 and 2010-2015, respectively.
Conclusions: Survival of patients with HCC has improved significantly over time in a single center in South Korea. Analysis is ongoing to determine the causes of the improved outcomes.