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Clinical outcomes of a cohort series of patients with hepatocellular carcinoma in a hepatitis B virus‐endemic area
Author(s) -
Kwak HeeWon,
Park JoongWon,
Nam ByungHo,
Yu Ami,
Woo Sang Myung,
Kim Tae Hyun,
Kim Seong Hoon,
Koh Young Hwan,
Kim Hyun Beom,
Park Sang Jae,
Lee Woo Jin,
Hong Eun Kyung,
Kim ChangMin
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12470
Subject(s) - medicine , hepatocellular carcinoma , cohort , gastroenterology , hazard ratio , hepatitis b virus , proportional hazards model , stage (stratigraphy) , confidence interval , immunology , virus , paleontology , biology
Background and Aims To evaluate the clinical outcomes of patients with hepatocellular carcinoma ( HCC ) and compare the findings with that of a previous cohort. Methods Overall, 1972 HCC patients diagnosed and treated at the N ational C ancer C enter, K orea between 2004 and 2009 were enrolled. The data of this cohort were compared with those of a previous cohort (2000–2003) from the same institution. Results I n all (mean age, 56.4 years; 1642 men), 74.6% was hepatitis B virus ( HBV ) positive, 81.6% were C hild– P ugh ( CP ) class A, and 64.4% was B arcelona C linic L iver C ancer ( BCLC ) stage C. The modified U nion for I nternational C ancer C ontrol (m UICC ) stage I , II , III , IVa , and IVb was found in 8.9%, 29.6%, 24.8%, 23.1%, and 13.6% patients, respectively. The most common initial treatment was transarterial chemotherapy (58.3%), followed by resection (18.6%). The 5‐year survival rate of BCLC stage 0, A, B, and C were 79.6%, 67.2%, 33.9%, and 17.1%, respectively. The performance status, BCLC stage, m UICC stage, CP class, model for end‐stage liver disease score, tumor characteristics, portal vein tumor invasion, and serum alpha‐fetoprotein level proved to be independent prognostic variables. Overall survival in the present cohort was better than that in the previous cohort (hazard ratio, 0.829; 95% confidence interval, 0.754–0.912), especially for advanced HCC patients with HBV ‐positive status. Conclusions This cohort study provides valuable insights into the characteristics of HCC in K orean patients. Our findings may help develop clinical trials, treatment strategies, and prognosis systems for HCC patients in HBV ‐endemic areas.