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Temporal improvement in survival of patients with hepatocellular carcinoma in a hepatitis B virus‐endemic population
Author(s) -
Kim Bo Hyun,
Lim YoungSuk,
Kim EunYang,
Kong HyunJoo,
Won YoungJoo,
Han Seungbong,
Park Sohee,
Hwang Jae Seok
Publication year - 2018
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.13848
Subject(s) - medicine , hepatocellular carcinoma , hepatitis b virus , cohort , population , gastroenterology , hepatitis b , liver cancer , liver function , univariate analysis , oncology , multivariate analysis , immunology , virus , environmental health
Background and Aim Over the past decade, the management of hepatocellular carcinoma (HCC) and viral hepatitis has been improved. We explored survival trends and factors affecting survival of HCC in a hepatitis B virus (HBV)‐endemic population. Methods From 31 521 and 38 167 HCC registrants to the population‐based national cancer registry in Korea, an HBV‐endemic country, in the period of 2003–2005 and 2008–2010, we randomly sampled cohorts of 4515 and 4582 patients, respectively, for the investigation of clinical characteristics and survival. Results Compared with Cohort 2003–2005, Cohort 2008–2010 had significantly better liver function (Child–Turcotte–Pugh class A, 64.2% vs 71.6%; P < 0.001) and had more advanced tumor stages (Barcelona Clinic Liver Cancer stage B–D, 45.8% vs 50.4%; P < 0.001). HBV was the predominant cause of HCC in both cohorts (62.5% vs 62.2%; P = 0.70). Cohort 2008–2010 had significantly better overall survival than Cohort 2003–2005 by age‐adjusted univariate, multivariable, and propensity score‐matched analyses (median survival time, 17.2 vs 28.4 months; P < 0.001). In a subcohort analysis, a consistently significant inter‐cohort improvement in survival was observed only in patients with HBV‐related HCC (median survival, 16.1 vs 30.4 months; P < 0.001). The annual number of patients with HCC receiving oral antiviral agents for HBV precipitously increased from 93 in 2005 to 28 520 in 2010 in the country. Conclusions The consistent improvement in survival of patients with HCC was confined to HBV‐related HCC subcohort over the last decade in an HBV‐endemic population. The survival improvement coincided with the exponential use of oral antiviral agents for HBV in the patients.