Hong Sung Yeon, Kang Mee Joo, Kim Taegyu, Jung Kyu-Won, Kim Bong-Wan
Department of Liver Transplantation and Hepatobiliary Surgery, Ajou University School of Medicine, Suwon, Korea.
Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea.
Ann Hepatobiliary Pancreat Surg. 2022 Aug 31;26(3):211-219. doi: 10.14701/ahbps.22-044. Epub 2022 Aug 8.
BACKGROUNDS/AIMS: Historically, incidence and survival analysis and annual traits for primary liver cancer (LC) has not been investigated in a population-based study in Korea. The purpose of the current study is to determine incidence, survival rate of patients with primary LC in Korea.
We conducted a retrospective cohort study using Korea Central Cancer Registry based on the Korea National Cancer Incidence Database. Statistical analysis including crude rate and age-standadized rate (ASR) of incidence and mortality was performed for LC patients registered with C22 code in International Classification of Diseases, tenth revision from 1999 to 2019. Subgroup analysis was performed for hepatocellular carcinoma (HCC, C22.0) and intrahepatic cholangiocarcinoma (IHCC, C22.1).
The crude incidence rate of HCC (21.0 to 22.8 per 100,000) and IHCC (2.3 to 5.6 per 100,000) increased in the observed period from 1999 to 2019. The ASR decreased in HCC (20.7 to 11.9 per 100,000) but remained unchanged in IHCC (2.4 to 2.7 per 100,000). The proportion of HCC patients diagnosed in early stages (localized or regional Surveillance, Epidemiology, and End Results or SEER stage) increased significantly over time. As expected, 5-yeat survival rate of HCC was greatly improved, reaching 42.4% in the period between 2013 and 2019. This trait was more prominent in localized SEER stage. On the other hand, the proportion of IHCC patients diagnosed in localized stage remained unchanged (22.9% between 2013 and 2019), although ASR and 5-year survival rate showed minor improvements.
A great improvement in survival rate was observed in patients with newly diagnosed HCCs. It was estimated to be due to an increase in early detection rate. On the contrary, detection rate of an early IHCC was stagnant with a minor improvement in prognosis.
背景/目的：以往，韩国尚未在基于人群的研究中对原发性肝癌（LC）的发病率、生存率分析及年度特征进行调查。本研究的目的是确定韩国原发性LC患者的发病率和生存率。
我们基于韩国国家癌症发病率数据库，利用韩国中央癌症登记处进行了一项回顾性队列研究。对1999年至2019年国际疾病分类第十版中登记为C22编码的LC患者进行了包括发病率和死亡率的粗率及年龄标准化率（ASR）在内的统计分析。对肝细胞癌（HCC，C22.0）和肝内胆管癌（IHCC，C22.1）进行了亚组分析。
在1999年至2019年的观察期内，HCC（每10万人中21.0至22.8例）和IHCC（每10万人中2.3至5.6例）的粗发病率有所上升。HCC的ASR有所下降（每10万人中20.7至11.9例），而IHCC的ASR保持不变（每10万人中2.4至2.7例）。随着时间的推移，早期（局限性或区域性监测、流行病学和最终结果或SEER分期）诊断的HCC患者比例显著增加。不出所料，HCC的5年生存率有了很大提高，在2013年至2019年期间达到了42.4%。这一特征在局限性SEER分期中更为突出。另一方面，尽管ASR和5年生存率有小幅改善，但局限性阶段诊断的IHCC患者比例保持不变（2013年至2019年期间为22.9%）。
新诊断的HCC患者的生存率有了很大提高。据估计，这是由于早期检测率的提高。相反，早期IHCC的检测率停滞不前，预后仅有小幅改善。
