J Liver Cancer.  2020 Sep;20(2):135-147. 10.17998/jlc.20.2.135.

Hepatocellular Carcinoma in Korea between 2012 and 2014: an Analysis of Data from the Korean Nationwide Cancer Registry

Affiliations
  • 1Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
  • 2Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
  • 3Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
  • 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  • 5Center for Liver Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
  • 6Department of Radiology, National Cancer Center, Goyang, Korea
  • 7Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
  • 8Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
  • 9Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea
  • 10Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea

Abstract

Background/Aims
Considering the high prevalence and mortality of hepatocellular carcinoma (HCC) in Korea, accurate statistics for HCC are important. We evaluated the characteristics of Korean patients with newly diagnosed HCC.
Methods
We retrospectively evaluated data from the Korean Primary Liver Cancer Registry (KPLCR). The baseline characteristics, treatment modalities, and overall survival (OS) of 4,572 patients with HCC registered in the KPLCR between 2012 and 2014 were investigated.
Results
At the time of HCC diagnosis, the median age was 60.0 years, with male predominance (79.6%). Hepatitis B virus infection was the most common etiology (59.1%). The rates of Barcelona Clinic Liver Cancer (BCLC) stages 0, A, B, C, and D at diagnosis were 3.9%, 36.9%, 12.5%, 39.4%, and 7.3%, respectively. The proportion of very early or early stage HCC at diagnosis (BCLC stage 0 or A) in the 2012-2014 cohort was significantly lower than that in the 2008-2011 cohort (40.8% vs. 48.3%, P<0.001). Transarterial therapy (37.5%) was the most commonly performed initial treatment, followed by surgical resection (19.8%), best supportive care (19.1%), and local ablation (10.6%). The median OS was 2.9 years, and the 1-, 3-, and 5-year OS rates were 67.7%, 49.3% and 41.9%, respectively. The OS rate of the 2012-2014 cohort was significantly higher than that of the 2008-2011 cohort (log-rank, P<0.001).
Conclusions
The OS of HCC patients registered in the KPLCR between 2012 and 2014 significantly improved. Nevertheless, as about half of the HCC patients were diagnosed at an advanced stage, vigorous and optimized HCC screening strategies should be implemented.

Keyword

Epidemiology; Hepatocellular carcinoma; Hepatitis B; Korea; Survival

Figure

  • Figure 1 Initial treatment modalities of the study population (A) and subgroups according to the Barcelona Clinic Liver Cancer (BCLC) stage (B), stage A (C), stage B (D), stage C (E), and stage D (F). *Combination therapy was defined as combined treatment with local ablation transarterial therapy; †Miscellaneous therapies were defined as unclassifiable treatment modalities (i.e., combination therapies other than transarterial therapy and local ablation therapy).

  • Figure 2 Overall survival curves for Korean patients with hepatocellular carcinoma in 2012–2014, 2008–2011, and 2003–2005. HR, hazard ratio; CI, confidence interval.

  • Figure 3 Overall survival curves for the subgroups divided by the Child-Turcotte-Pugh classes. (A), modified Union for International Cancer Control stages (B), Barcelona Clinic Liver Cancer stages (C), and the serum levels of alpha-fetoprotein (D). CTP, Child-Turcotte-Pugh; AFP, alpha-fetoprotein.


Cited by  4 articles

Efficacy of Hepatic Arterial Infusion Chemotherapy and Radiofrequency Ablation against Hepatocellular Carcinoma Refractory to Transarterial Chemoembolization and Vascular Variation: A Case Study
Sang Yi Moon, Sang Young Han, Yang-Hyun Baek
Kosin Med J. 2021;36(2):161-168.    doi: 10.7180/kmj.2021.36.2.161.

A case report of advanced hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy and sorafenib combination therapy followed by metastasectomy of lung and muscle metastases
Sang Yi Moon, Sang Young Han, Yang-Hyun Baek
J Liver Cancer. 2022;22(1):57-62.    doi: 10.17998/jlc.2021.12.20.

2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma

J Liver Cancer. 2023;23(1):1-120.    doi: 10.17998/jlc.2022.11.07.

Advancing Korean nationwide registry for hepatocellular carcinoma: a systematic sampling approach utilizing the Korea Central Cancer Registry database
Bo Hyun Kim, E Hwa Yun, Jeong-Hoon Lee, Geun Hong, Jun Yong Park, Ju Hyun Shim, Eunyang Kim, Hyun-Joo Kong, Kyu-Won Jung, Young-Suk Lim
J Liver Cancer. 2024;24(1):57-61.    doi: 10.17998/jlc.2024.03.03.


Reference

1. Sayiner M, Golabi P, Younossi ZM. Disease burden of hepatocellular carcinoma: a global perspective. Dig Dis Sci. 2019; 64:910–917.
2. El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007; 132:2557–2576.
3. National Cancer Center. Annual report of cancer statistics in Korea in 2016. Goyang: National Cancer Center;2018. p. 1–221.
4. Kim BH, Park JW. Epidemiology of liver cancer in South Korea. Clin Mol Hepatol. 2018; 24:1–9.
5. Cho EJ, Kim SE, Suk KT, An J, Jeong SW, Chung WJ, et al. Current status and strategies for hepatitis B control in Korea. Clin Mol Hepatol. 2017; 23:205–211.
6. Choi J, Han S, Kim N, Lim YS. Increasing burden of liver cancer despite extensive use of antiviral agents in a hepatitis B virus-endemic population. Hepatology. 2017; 66:1454–1463.
7. Chon YE, Jung KS, Kim MJ, Choi JY, An C, Park JY, et al. Predictors of failure to detect early hepatocellular carcinoma in patients with chronic hepatitis B who received regular surveillance. Aliment Pharmacol Ther. 2018; 47:1201–1212.
8. Kwon JW, Tchoe HJ, Lee J, Suh JK, Lee JH, Shin S. The impact of national surveillance for liver cancer: results from real-world setting in Korea. Gut Liver. 2020; 14:108–116.
9. Suh M, Song S, Cho HN, Park B, Jun JK, Choi E, et al. Trends in Participation Rates for the National Cancer Screening Program in Korea, 2002–2012. Cancer Res Treat. 2017; 49:798–806.
10. Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, Abecassis MM, et al. Diagnosis, staging, and management of hepatocellular carcinoma: 2018 practice guidance by the American Association for the Study of Liver Diseases. Hepatology. 2018; 68:723–750.
11. European Association For The Study Of The Liver; European Organisation For Research And Treatment Of Cancer. EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2012; 56:908–943.
12. Kim DY, Kim HJ, Han KH, Han SY, Heo J, Woo HY, et al. Real-life experience of sorafenib treatment for hepatocellular carcinoma in Korea: from GIDEON data. Cancer Res Treat. 2016; 48:1243–1252.
13. Choi SH, Seong J. Strategic application of radiotherapy for hepatocellular carcinoma. Clin Mol Hepatol. 2018; 24:114–134.
14. Yoon JS, Lee HA, Park JY, Kim BH, Lee IJ, Chon YE, et al. Hepatocellular carcinoma in Korea between 2008 and 2011: an analysis of Korean Nationwide Cancer Registry. J Liver Cancer. 2020; 20:41–52.
15. Sheu JC, Sung JL, Chen DS, Yang PM, Lai MY, Lee CS, et al. Growth rate of asymptomatic hepatocellular carcinoma and its clinical implications. Gastroenterology. 1985; 89:259–266.
16. Kudo M, Kitano M, Sakurai T, Nishida N. General rules for the clinical and pathological study of primary liver cancer, nationwide follow-up survey and clinical practice guidelines: the outstanding achievements of the Liver Cancer Study Group of Japan. Dig Dis. 2015; 33:765–770.
17. Llovet JM, Brú C, Bruix J. Prognosis of hepatocellular carcinoma: the BCLC staging classification. Semin Liver Dis. 1999; 19:329–338.
18. Lim YS, Sinn DH, Kim SH, Hwang JS, Han KH; Korea Central Cancer Registry. Characteristics and survival of Korean patients with hepatocellular carcinoma: a nationwide random sample study. J Liver Cancer. 2014; 14:97–107.
19. Ma C, Kesarwala AH, Eggert T, Medina-Echeverz J, Kleiner DE, Jin P, et al. NAFLD causes selective CD4(+) T lymphocyte loss and promotes hepatocarcinogenesis. Nature. 2016; 531:253–257.
20. Park SH, Jeon WK, Kim SH, Kim HJ, Park DI, Cho YK, et al. Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults. J Gastroenterol Hepatol. 2006; 21(1 Pt 1):138–143.
21. Choi SY, Kim D, Kim HJ, Kang JH, Chung SJ, Park MJ, et al. The relation between non-alcoholic fatty liver disease and the risk of coronary heart disease in Koreans. Am J Gastroenterol. 2009; 104:1953–1960.
22. Lee K, Sung JA, Kim JS, Park TJ. The roles of obesity and gender on the relationship between metabolic risk factors and non-alcoholic fatty liver disease in Koreans. Diabetes Metab Res Rev. 2009; 25:150–155.
23. Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, et al. 2018 Korean Society for the study of obesity guideline for the management of obesity in Korea. J Obes Metab Syndr. 2019; 28:40–45.
24. Kim BY, Won JC, Lee JH, Kim HS, Park JH, Ha KH, et al. Diabetes fact sheets in Korea, 2018: an appraisal of current status. Diabetes Metab J. 2019; 43:487–494.
25. Marrero JA, Fontana RJ, Su GL, Conjeevaram HS, Emick DM, Lok AS. NAFLD may be a common underlying liver disease in patients with hepatocellular carcinoma in the United States. Hepatology. 2002; 36:1349–1354.
26. Torzilli G, Donadon M, Marconi M, Palmisano A, Del Fabbro D, Spinelli A, et al. Hepatectomy for stage B and stage C hepatocellular carcinoma in the Barcelona Clinic Liver Cancer classification: results of a prospective analysis. Arch Surg. 2008; 143:1082–1090.
Full Text Links
  • JLC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr