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J Liver Cancer > Volume 14(2); 2014 > Article
Journal of the Korean Liver Cancer Study 2014;14(2):97-107.
DOI: https://doi.org/10.17998/jlc.14.2.97    Published online September 30, 2014.
Characteristics and Survival of Korean Patients with Hepatocellular Carcinoma: A Nationwide Random Sample Study
Young-Suk Lim1,2, Seung Hyung Kim1,3, Seung Hyung Kim1,4, Jae Seok Hwang1,5, Kwang-Hyub Han1,6
1The Korean Liver Cancer Study Group
2Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul
3Department of Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul
4Department of Radiology, Jeju National University School of Medicine, Jeju
5Department of Internal Medicine, Keimyung University School of Medicine, Daegu
6Department of Internal Medicine, Yonsei University College of Medicine, Liver Cirrhosis Clinical Research Center, Seoul, Korea
7Korea Central Cancer Registry
Correspondence:  Jae Seok Hwang,
Email: gastro@dsmc.or.kr
Kwang-Hyub Han,
Email: gihankhys@yuhs.ac.kr
Copyright ©2014 by The Korean Liver Cancer Association
Abstract
Background/Aims
Given the high incidence and mortality rate of hepatocellular carcinoma (HCC), ensuring high quality of registry data is important for the improvement of health service. Registries by voluntary reporting often lack case completeness and may cause selection bias. A statutory Korean Central Cancer Registry (KCCR) has case completeness and provides accurate information on HCC incidence, but provides limited information about HCC characteristics.
Methods
The Korean Liver Cancer Study Group (KLCSG) and the KCCR jointly built a nationwide cohort of patients who were diagnosed with HCC between 2003 and 2005. Out of 31,521 new HCC cases that were registered at the KCCR between 2003 and 2005, 4,630 cases (14.7% of total HCC cases) were randomly selected and abstracted from 32 hospitals nationwide, and followed up until December 2011. After excluding 110 patients who met the exclusion criteria, a total of 4,520 HCC patients were analyzed.
Results
Mean age at the diagnosis of HCC was 57.1±10.8 years, and males comprised 81.0%. Hepatitis B was the predominant etiology (72%), and hepatitis C comprised 12%. Stage at diagnosis was 10%, 43%, 28%, 11% and 8% for modified International Union Against Cancer (mUICC) stages I, II, III, IV-A and IV-B, respectively. Initial treatment modalities were transarterial therapy in 53%, surgical resection in 10%, local ablation in 7%, and liver transplantation in 1%. The median survival was 1.4 years, and the 1-, 3-, and 5-year survival rates were 56%, 35% and 27%, respectively. Age, gender, Child-Pugh class, etiology, tumor stage at diagnosis, and treatment modality were factors independently related to survival.
Conclusions
About half of HCC patients are diagnosed at advanced stages in Korea. Curativeintent treatments are rarely applied to patients. This data provides unbiased information about the characteristics and outcome of HCC patients in Korea. (J Liver Cancer 2014;14:97- 107)
Key Words: Hepatocellular carcinoma; Korea; Survival; Prognostic factor
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