Department of Radiation Oncology, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea.
Can J Gastroenterol Hepatol. 2021 Jan 4;2021:6640121. doi: 10.1155/2021/6640121. eCollection 2021.
We sought to analyze the preferred treatment modality by age and liver function in South Korea.
The Korean Liver Cancer Study Group randomly extracted the data of patients with hepatocellular carcinoma (HCC) enrolled in the Korean Central Cancer Registry from 2008 to 2014 from approximately 50 hospitals nationwide. After excluding distant and lymphatic metastases, the treatment preference for patients with a single lesion (excluding PVT (portal vein thrombosis), hepatic vessels, and bile duct invasion) and with PVT was evaluated in 7559 patients. Patients were grouped by age, and baseline liver function was divided based on the Child-Pugh class (CPC) , , and .
For a single HCC, the majority of patients selected transarterial therapy as the initial treatment, followed by surgical resection and local ablative therapy. The surgical resection rate decreased significantly with age ( < 0.001), and the transarterial therapy rate significantly increased ( < 0.001). For CPC C, liver transplantation was significantly increased to 11.5%, and 36.3% of patients received no treatment. In HCC with PVT, the transarterial therapy rate was the highest, followed by the rate of abandonment of treatment. The proportion of no treatment significantly increased with age ( < 0.001). In CPC C, transarterial therapy and systemic therapy were attempted in 15.4% and 5.8% of patients, respectively.
Age and liver function have a significant impact on the therapeutic decision-making of HCC patients in Korea. In unfavorable conditions, surgical resection was less favored in patients with single tumors, and no treatment was preferred in patients with PVT.
本研究旨在分析韩国不同年龄和肝功能患者对肝癌治疗方法的选择偏好。
韩国肝癌研究组从全国约 50 家医院的韩国中央癌症注册中心 2008 至 2014 年期间入组的肝癌患者中随机提取数据。排除远处和淋巴转移后，对 7559 例单个肿瘤（不包括门静脉癌栓、肝血管和胆管侵犯）和伴有门静脉癌栓患者的治疗偏好进行评估。根据年龄和基线肝功能将患者分组，Child-Pugh 分级（CPC）为 A、B 和 C。
对于单个 HCC，大多数患者选择经动脉治疗作为初始治疗，其次是手术切除和局部消融治疗。手术切除率随年龄增长显著下降（<0.001），经动脉治疗率显著上升（<0.001）。对于 CPC C，肝移植显著增加到 11.5%，36.3%的患者未接受治疗。对于伴有门静脉癌栓的 HCC，经动脉治疗率最高，其次是放弃治疗的比例。年龄越大，未治疗的比例越高（<0.001）。在 CPC C 中，分别有 15.4%和 5.8%的患者尝试经动脉治疗和全身治疗。
年龄和肝功能对韩国 HCC 患者的治疗决策有显著影响。在不利条件下，单个肿瘤患者不太倾向于选择手术切除，伴有门静脉癌栓的患者更倾向于不治疗。
