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. 2019 Oct 17;14(10):e0223678.
doi: 10.1371/journal.pone.0223678. eCollection 2019.

Changes in real-life practice for hepatocellular carcinoma patients in the Republic of Korea over a 12-year period: A nationwide random sample study

Beom Kyung Kim  1   2 , Do Young Kim  1   2 , Kwang-Hyub Han  1   2 , Jinsil Seong  3
Affiliations

Changes in real-life practice for hepatocellular carcinoma patients in the Republic of Korea over a 12-year period: A nationwide random sample study

Beom Kyung Kim et al. PLoS One. .

Abstract

Backgrounds & aims: Comprehensive analyses through nationwide hepatocellular carcinoma (HCC) registries are important to understand health care issues. We assessed changes in real-life practice for HCC over a long time period.

Methods: The Korean Liver Cancer Association and the Korean Central Cancer Registry jointly established the nationwide cohorts of newly diagnosed HCC patients between 2003 and 2005 and between 2008 and 2014. According to sorafenib reimbursement in the Republic of Korea (January 2011), patients were divided into early (E-Cohort: 2003~2010) and late (L-Cohort: 2011~2014) cohorts.

Results: L-Cohort (n = 4776) comprised patients with older age (60.8 vs. 58.3 years), higher proportions of patients with well-preserved liver function (75.6% vs. 68.2%) and non-viral etiologies (28.6% vs. 19.4%), and lower proportion of patients with Barcelona Clinic Liver Cancer [BCLC] 0~A stage (46.2% vs. 53.9%) than E-Cohort (n = 8203) (all p<0.05). Proportions of patients undergoing curative treatments were higher in L-Cohort than in E-Cohort (55.0% vs. 35.1%, 23.2 vs. 11.3%, and 17.3% vs. 9.6% in BCLC 0A, B, and C stages, respectively; all p<0.05). Accordingly, compared with that in E-Cohort, overall survival in L-Cohort significantly improved in patients with BCLC 0~A, B, and C stages (all p<0.05). As first-line treatment, 62.4% underwent locoregional treatments (LRTs), whereas only 9.7% received sorafenib, among BCLC stage C patients in L-Cohort.

Conclusions: For the past 12 years, curative treatments became more widely available to BCLC 0~A, B, and C stage patients, generally improving prognosis. Despite sorafenib reimbursement, LRTs remain the mainstay of first-line treatment for BCLC C stage patients.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Kaplan-Meier analysis of overall survival between the E-Cohort and L-Cohort.
Fig 2
Fig 2. Kaplan-Meier analysis of overall survival between the E-Cohort and L-Cohort when stratified by BCLC stage 0~A (A), B (B), C (C), and D (D).
Fig 3
Fig 3. Kaplan-Meier analysis of overall survival between the E-Cohort and L-Cohort among patients with HBV-related HCC.
See this image and copyright information in PMC

References

    1. Yang JD, Roberts LR. Hepatocellular carcinoma: A global view. Nat Rev Gastroenterol Hepatol. 2010;7: 448–458. 10.1038/nrgastro.2010.100 - DOI - PMC - PubMed
    1. El-Serag HB. Hepatocellular carcinoma. N Engl J Med. 2011;365: 1118–1127. 10.1056/NEJMra1001683 - DOI - PubMed
    1. Llovet JM, Burroughs A, Bruix J. Hepatocellular carcinoma. Lancet. 2003;362: 1907–1917. 10.1016/S0140-6736(03)14964-1 - DOI - PubMed
    1. Kim BH, Park JW. Epidemiology of liver cancer in South Korea. Clin Mol Hepatol. 2018;24: 1–9. 10.3350/cmh.2017.0112 - DOI - PMC - PubMed
    1. Sung JL. Hepatitis B virus eradication strategy for Asia. The Asian Regional Study Group. Vaccine. 1990;8 Suppl: S95–99 10.1016/0264-410x(90)90227-d - DOI - PubMed

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