Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Republic of Korea.
Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.
PLoS One. 2022 Mar 24;17(3):e0265668. doi: 10.1371/journal.pone.0265668. eCollection 2022.
The incidence and mortality of hepatocellular carcinoma (HCC) have decreased over time in South Korea, where hepatitis B virus (HBV) in endemic. This study investigated the changes in the characteristics and clinical outcomes of HCC patients in Korea.
Patients initially diagnosed with HCC and treated at the National Cancer Center, Korea between 2000 and 2015 (n = 4,291) were followed up until February 2017. Differences in patient characteristics and outcomes were compared between chronological cohorts: cohort A (2000-2004, n = 1,157) vs. B (2005-2009, n = 1,678) vs. C (2010-2015, n = 1,456).
The median age of the patient cohort was 57 years (range, 13-98 years), and male predominance was noted (81.6%). HBV infection was the most common etiology (74.8%). The proportion of patients diagnosed with good liver function and small tumors (<2 cm) increased significantly over time: 74.6%, 79.9%, and 87.4% for Child-Pugh class A (p<0.001) and 8.0%, 8.5%, and 12.0% for modified UICC stage I (p<0.001) in cohorts A, B, and C, respectively. Median overall survival improved significantly over time: 14.4 months (95% confidence interval [CI], 12.0-16.8 months), 22.9 months (95% CI, 20.3-25.5 months), and 53.6 months (95% CI, 45.7-61.5 months) in cohorts A, B, and C, respectively. HBV-related patients showed significantly improved survival (12.7 vs. 20.4 vs. 64.5 months, p<0.001) associated with the use of antiviral treatments (adjusted hazard ratio, 0.72; 95% CI, 0.64-0.80).
The survival of patients with HCC, especially HBV-related HCC, has improved significantly over time in Korea.
在乙型肝炎病毒（HBV）流行的韩国，肝细胞癌（HCC）的发病率和死亡率随时间呈下降趋势。本研究旨在探讨韩国 HCC 患者特征和临床结局的变化。
本研究回顾性分析了 2000 年至 2015 年在韩国国家癌症中心接受治疗的 4291 例 HCC 患者的临床资料，随访至 2017 年 2 月。通过比较三个时间队列（A 队列：2000-2004 年，n=1157；B 队列：2005-2009 年，n=1678；C 队列：2010-2015 年，n=1456）患者的特征和结局，探讨 HCC 患者的变化趋势。
本研究队列的中位年龄为 57 岁（范围 13-98 岁），男性占 81.6%。HBV 感染是最常见的病因（74.8%）。随着时间的推移，患者肝功能良好和肿瘤较小（<2cm）的比例显著增加：A、B 和 C 队列的 Child-Pugh 分级 A 分别为 74.6%、79.9%和 87.4%（p<0.001），改良 UICC 分期 I 分别为 8.0%、8.5%和 12.0%（p<0.001）。中位总生存期随时间显著改善：A、B 和 C 队列分别为 14.4 个月（95%CI，12.0-16.8 个月）、22.9 个月（95%CI，20.3-25.5 个月）和 53.6 个月（95%CI，45.7-61.5 个月）。HBV 相关 HCC 患者的生存显著改善（12.7 vs. 20.4 vs. 64.5 个月，p<0.001），与抗病毒治疗的应用相关（调整后的危险比，0.72；95%CI，0.64-0.80）。
韩国 HCC 患者，尤其是 HBV 相关 HCC 患者的生存状况随时间显著改善。
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