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HOME > J Liver Cancer > Volume 25(1); 2025 > Article
Correspondence
 Correspondence to editorial on “Evolving trends in epidemiology, etiology, and treatment patterns for hepatocellular carcinoma in South Korea”
Ji Won Han1,2,3orcid, Bo Hyun Kim1,4orcid
Journal of Liver Cancer 2025;25(1):7-8.
DOI: https://doi.org/10.17998/jlc.2025.02.17
Published online: February 27, 2025

1The Korean Liver Cancer Association, Seoul, Korea

2The Catholic University Liver Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea

3Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

4Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Korea

Corresponding author: Bo Hyun Kim, Center for Liver and Pancreatobiliary Cancer, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang 10408, Korea E-mail: bohkim@ncc.re.kr
• Received: February 16, 2025   • Accepted: February 17, 2025

© 2025 The Korean Liver Cancer Association.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Dear Editor,
We read with great interest the editorial by Hwang and Yang,1 which provided valuable insights into the evolving trends in hepatocellular carcinoma (HCC) epidemiology, etiology, and treatment patterns. The detailed analysis of the National Health Insurance Service database highlights significant changes in HCC management over time.2 However, we believe further exploration using comprehensive national data could deepen our understanding of the association between evolving treatment patterns and improved patients’ outcomes, which is in line with the conclusion of the editorial.
One critical area for further investigation is a focus on survival data. While our analysis could not delve into survival trends, a prior report suggested that survival rates have been increasing over time in South Korea,3 reflecting advancements in early detection and treatment modalities. A previous survey showed that early detection of HCC was higher in the surveillance group compared to the non-surveillance group in South Korea.4 Nevertheless, whether changes in initial treatment patterns over time would have a positive impact on patient outcomes needs to be elucidated, considering advancements in minimally invasive surgeries5 and systemic treatments, including immune checkpoint inhibitors. To elucidate these associations, combining national survival statistics with treatment and patient-level data could be instrumental.
More specifically, subgroup analyses exploring survival outcomes according to initial treatment patterns would identify advancements in each treatment modality in terms of technical, pharmacological aspects, or patient selection. For example, survival of transarterial chemoembolization-treated patients gradually improved over time in an Italian Liver Cancer database.6 Analyses regarding baseline liver function at diagnosis and investigating treatment patterns in each subgroup would also be helpful, considering a previous study that showed treatment patterns can impact patient survival in HCC patients with Child-Pugh class B.7 Moreover, the influence of second-line systemic treatment on patient outcomes warrants closer examination. As systemic therapies diversify, understanding patterns of second-line treatment adoption and their impact on survival could guide future therapeutic strategies.
If integrated with survival data, analyses of treatment pattern changes could provide even more meaningful insights to inform evidence-based treatment strategies and guide future clinical research on HCC. This approach underscores the importance of utilizing comprehensive datasets to enhance both clinical and policy-making frameworks, ultimately improving patient care and advancing HCC research.

Conflicts of Interest

The authors have no conflicts of interest to disclose.

Ethics Statement

Not applicable.

Funding Statement

None.

Data Availability

Not applicable.

Author Contributions

Writing - original draft: JWH, BHK

Writing - review & editing: BHK

  • 1. Hwang SY, Yang JD. Evolving trends in epidemiology, etiology, and treatment patterns for hepatocellular carcinoma in South Korea. J Liver Cancer 2024;Dec 5 doi: 10.17998/jlc.2024.12.04. [Epub ahead of print].Article
  • 2. Han JW, Sohn W, Choi GH, Jang JW, Seo GH, Kim BH, et al. Evolving trends in treatment patterns for hepatocellular carcinoma in Korea from 2008 to 2022: a nationwide population-based study. J Liver Cancer 2024;24:274−285.ArticlePubMedPMCPDF
  • 3. Chon YE, Lee HA, Yoon JS, Park JY, Kim BH, Lee IJ, et al. Hepatocellular carcinoma in Korea between 2012 and 2014: an analysis of data from the Korean Nationwide Cancer Registry. J Liver Cancer 2020;20:135−147.ArticlePubMedPMCPDF
  • 4. 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.ArticlePubMedPMC
  • 5. Ciria R, Gomez-Luque I, Ocaña S, Cipriani F, Halls M, Briceño J, et al. A systematic review and meta-analysis comparing the short- and long-term outcomes for laparoscopic and open liver resections for hepatocellular carcinoma: updated results from the European Guidelines Meeting on Laparoscopic Liver Surgery, Southampton, UK, 2017. Ann Surg Oncol 2019;26:252−263.ArticlePubMedPDF
  • 6. Pelizzaro F, Haxhi S, Penzo B, Vitale A, Giannini EG, Sansone V, et al. Transarterial chemoembolization for hepatocellular carcinoma in clinical practice: temporal trends and survival outcomes of an iterative treatment. Front Oncol 2022;12:822507. ArticlePubMedPMC
  • 7. Jeon D, Song GW, Lee HC, Shim JH. Treatment patterns for hepatocellular carcinoma in patients with Child-Pugh class B and their impact on survival: a Korean nationwide registry study. Liver Int 2022;42:2830−2842.PubMed

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        Correspondence to editorial on “Evolving trends in epidemiology, etiology, and treatment patterns for hepatocellular carcinoma in South Korea”
        J Liver Cancer. 2025;25(1):7-8.   Published online February 27, 2025
        DOI: https://doi.org/10.17998/jlc.2025.02.17
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