Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City 83302, Taiwan.
Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung City 83301, Taiwan.
Viruses. 2022 Dec 31;15(1):126. doi: 10.3390/v15010126.
Hepatocellular carcinoma (HCC) is a major cause of cancer death in Taiwan, and in the past 30-40 years, Taiwan has been committed to its prevention and treatment. We aimed to investigate the secular trends of characteristics and the survival of HCC in recent decades after making increased efforts. Between 2011 and 2019, a total of 73,817 cases were enrolled from the TCR database. The overall male-to-female ratio was 7/3. The overall, male and female mean ages increased from 63.8 to 66.1 years, 62.0 to 64.3 years and 68.3 to 70.4 years, respectively. After dividing by viral etiologies and gender, the mean age showed increasing trends in all subgroups. The proportions of HBV-HCC, HCV-HCC, HBV+HCV-HCC and Non-HBV+non-HCV-HCC were 48.3%, 25.2%, 5.3% and 21.3% in males, compared with 25.5%, 48.6%, 5.3% and 20.5% in females, respectively. The 5-year survival rates of BCLC stages 0, A, B, C and D were 70%, 58%, 34%, 11% and 4%, respectively. The proportion of BCLC stage 0 increased from 6.2% to 11.3%. Multivariate analysis showed that being female, older age, diagnostic year, BCLC stages, hospital level, body mass index, smoking, alcohol consumption, AFP, Child-Pugh classification and HBV/HCV status were independent predictors for survival. In recent decades, the overall survival of HCC in Taiwan has been improving and might be partly associated with increased BCLC 0 and Child-Pugh A patients, while with the consequent age of patients increasing over time. The proportion of viral-related HCC is decreasing, while nonviral-related HCC is increasing.
肝细胞癌 (HCC) 是台湾癌症死亡的主要原因，在过去的 30-40 年中，台湾一直致力于其预防和治疗。我们旨在研究在过去几十年中做出更多努力后 HCC 的特征和生存的长期趋势。在 2011 年至 2019 年期间，共从 TCR 数据库中招募了 73817 例患者。总体男女比例为 7/3。总体、男性和女性的平均年龄分别从 63.8 岁增加到 66.1 岁、62.0 岁增加到 64.3 岁和 68.3 岁增加到 70.4 岁。按病毒病因和性别划分后，所有亚组的平均年龄均呈上升趋势。男性 HBV-HCC、HCV-HCC、HBV+HCV-HCC 和非 HBV+非 HCV-HCC 的比例分别为 48.3%、25.2%、5.3%和 21.3%，而女性分别为 25.5%、48.6%、5.3%和 20.5%。BCLC 分期 0、A、B、C 和 D 的 5 年生存率分别为 70%、58%、34%、11%和 4%。BCLC 分期 0 的比例从 6.2%增加到 11.3%。多因素分析显示，女性、年龄较大、诊断年份、BCLC 分期、医院级别、体重指数、吸烟、饮酒、AFP、Child-Pugh 分类和 HBV/HCV 状态是生存的独立预测因素。在过去的几十年中，台湾 HCC 的总体生存率一直在提高，这可能部分与 BCLC 0 和 Child-Pugh A 患者的增加有关，而随着时间的推移，患者的年龄也在不断增加。病毒相关性 HCC 的比例正在下降，而非病毒相关性 HCC 的比例正在增加。
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