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. 2021 Aug 31:8:1023-1034.
doi: 10.2147/JHC.S321346. eCollection 2021.

Liver Cancer Survival: A Real World Observation of 45 Years with 32,556 Cases

Jian-Guo Chen  1   2 , Jian Zhu  1 , Yong-Hui Zhang  1 , Yong-Sheng Chen  1 , Lu-Lu Ding  1 , Hai-Zhen Chen  2 , Ai-Guo Shen  2 , Gao-Ren Wang  2
Affiliations

Liver Cancer Survival: A Real World Observation of 45 Years with 32,556 Cases

Jian-Guo Chen et al. J Hepatocell Carcinoma. .

Abstract

Background and aims: To explore the long-term trend of liver cancer survival, based on the real-world data (RWD) in the past 45 years from a population-based cancer registry, in Qidong, China.

Methods: A number of 32,556 patients with liver cancer were registered during the period of 1972 to 2016. Mixed methods by active and passive follow-up were performed. Life table method was employed for survival analysis by SPSS22 software. Wilcoxon (Gehan) statistics was considered as a significant test. Relative survival was calculated by using SURV software, and its annual percent change (APC) was estimated by the Joinpoint Regression Program.

Results: The overall observed survival (OS) rates of 1-, 5-, 10-, and 20-year rates from the data series were 18.51%, 6.28%, 4.03%, and 2.84%, and their relative survival (RS) rates were 18.88%, 6.95%, 4.96%, and 4.49%, respectively. For 24,338 male cases, the 5-year OS and RS rates were 5.93% and 6.54%, and for 8218 female cases, 7.34% and 8.15%, respectively, with P values less than 0.01. Survival rates of liver cancer from three 15-year periods of 1972-1986, 1987-2001, and 2002-2016 have increased significantly, with 5-year OS rates of 2.02%, 4.40%, and 10.76%, 5-year RS rates of 2.18%, 4.83%, and 12.18%; 10-year OS and RS rates of 0.95%, 3.00%, and 7.02%, vs 1.13%, 3.65%, and 8.96%, respectively, showing a very significant upward trend (P<0.01). There are significant differences among age groups (P<0.01): those aged 55-64 demonstrated the best OS and RS rates of 5-year, being 8.44% and 9.09%, respectively.

Conclusion: There are significant gender and age differences in the survival rate of liver cancer in Qidong. RWD indicates the relative lower survival rate of liver cancer in this area, but great improvement has been achieved over the past decades.

Keywords: Qidong; liver cancer; long-term trend; real-world data; survival rate.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Overall OS of liver cancer by sex in Qidong, 1972–2016. Gehan statistic is 11.156, P = 0.0008, showing a difference in survival between males and females.
Figure 2
Figure 2
Five-year RS trends of liver cancer by sex in Qidong, 1972–2016. APCs with 2 segments (1 joinpoint) were 4.17% in 1972–2008, and 15.38% in 2008–2016 in males; and were 2.17% in 1972–2006, and 17.04% in 2006–2016 in females (*: P values are less than 0.05).
Figure 3
Figure 3
OS of liver cancer by age group in Qidong, 1972–2016. Gehan statistic is 214.561, P = 0.0000, showing differences among age groups (0–14 is not included, due to cases were less than 100).
Figure 4
Figure 4
Five-year RS trends of liver cancer by age group in Qidong, 1972–2016. Joinpoint Regression shows that APCs of 5-year RS for those aged at 25–74 were increased markedly (Ps <0.05*), but not significant at age of over 75. Down trend was seen at age group of 15–24 but P > 0.05.
Figure 5
Figure 5
OS of liver cancer by 15-year period in Qidong, 1972–2016. Gehan statistic of total test is 1001.303, P = 0.0000. Group comparison [period testing]: Early period (blue) vs Middle period (green): 0.181, P = 0.6705; Early period vs Recent period (red): 599.730, P = 0.0000; Middle period vs Recent period: 707.413, P =0.0000.
Figure 6
Figure 6
RS trends of liver cancer by survival year in Qidong, 1972–2016. Joinpoint Regression shows that the APC of 10-year RS, the APCs of 5-year RS with 2 segments, and APCs of 1-year RS with 4 segments were all significantly different from zero at the level of alpha = 0.05*.
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