Han Ji Won, Sohn Won, Choi Gwang Hyeon, Jang Jeong Won, Seo Gi Hyeon, Kim Bo Hyun, Choi Jong Young
The Korean Liver Cancer Association, Seoul, Korea.
The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Liver Cancer. 2024 Sep;24(2):274-285. doi: 10.17998/jlc.2024.08.13. Epub 2024 Aug 26.
BACKGROUNDS/AIMS: The treatment landscape for hepatocellular carcinoma (HCC) has significantly evolved over the past decade. We aimed to analyze trends in treatment patterns for HCC using a nationwide claims database from the Korean Health Insurance Review and Assessment Service.
This retrospective population-based cohort study analyzed 171,002 newly diagnosed HCC patients between 2008 and 2022. Etiologies and treatment modalities were categorized based on the ICD-10 codes and insurance data.
The annual incidence decreased from 11,814 in 2008 to 10,443 in 2022. However, patients aged ≥70 increased noticeably, with those aged ≥80 rising from 3.8% in 2008 to 13.1% in 2022. From 2008 to 2022, the predominant cause of hepatitis B virus decreased from 68.9% to 59.7%, whereas nonalcoholic fatty liver disease increased from 8.9% to 15.8%. The initial treatment trends shifted: surgical resection and systemic therapy increased from 12.2% to 21.3% and from 0.2% to 9.6%, whereas transarterial therapy decreased from 49.9% to 36.6%. Best supportive care decreased from 31.7% to 21.3%. In the subgroup analysis, laparoscopic resection rate increased from 10.6% to 60.6% among the surgical resections. Sorafenib initially accounted for 100%, lenvatinib peaked at 36.5% in 2021, and atezolizumab-bevacizumab became the most widely used (63.1%) by 2022 among the systemic therapies.
This study demonstrates the temporal changes in the treatment patterns of Korean HCC patients. Surgical resection, particularly laparoscopic liver resection, and systemic therapy has increased significantly. These changes may have been influenced by reimbursement policies and advances in clinical research.
背景/目的：在过去十年中，肝细胞癌（HCC）的治疗格局发生了显著变化。我们旨在利用韩国健康保险审查与评估服务中心的全国索赔数据库，分析HCC治疗模式的趋势。
这项基于人群的回顾性队列研究分析了2008年至2022年间171,002例新诊断的HCC患者。病因和治疗方式根据国际疾病分类第10版代码和保险数据进行分类。
年发病率从2008年的11,814例降至2022年的10,443例。然而，≥70岁的患者显著增加，≥80岁的患者从2008年的3.8%升至2022年的13.1%。从2008年到2022年，乙型肝炎病毒的主要病因从68.9%降至59.7%，而非酒精性脂肪性肝病从8.9%增至15.8%。初始治疗趋势发生了变化：手术切除和全身治疗从12.2%增至21.3%，从0.2%增至9.6%，而经动脉治疗从49.9%降至36.6%。最佳支持治疗从31.7%降至21.3%。在亚组分析中，手术切除中腹腔镜切除率从10.6%增至60.6%。索拉非尼最初占100%，乐伐替尼在2021年达到峰值36.5%，到2022年，阿替利珠单抗-贝伐单抗在全身治疗中使用最为广泛（63.1%）。
本研究展示了韩国HCC患者治疗模式的时间变化。手术切除，尤其是腹腔镜肝切除和全身治疗显著增加。这些变化可能受到报销政策和临床研究进展的影响。
