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. 2022 Mar 24;17(3):e0265668.
doi: 10.1371/journal.pone.0265668. eCollection 2022.

Better survival of patients with hepatitis B virus-related hepatocellular carcinoma in South Korea: Changes in 16-years cohorts

Sang Il Choi  1 , Yuri Cho  1 , Moran Ki  2 , Bo Hyun Kim  1 , In Joon Lee  3 , Tae Hyun Kim  1   4 , Seong Hoon Kim  1 , Young Hwan Koh  3 , Hyun Beom Kim  3 , Eun Kyung Hong  1 , Chang-Min Kim  1 , Joong-Won Park  1   2
Affiliations

Better survival of patients with hepatitis B virus-related hepatocellular carcinoma in South Korea: Changes in 16-years cohorts

Sang Il Choi et al. PLoS One. .

Abstract

Aims: The incidence and mortality of hepatocellular carcinoma (HCC) have decreased over time in South Korea, where hepatitis B virus (HBV) in endemic. This study investigated the changes in the characteristics and clinical outcomes of HCC patients in Korea.

Methods: Patients initially diagnosed with HCC and treated at the National Cancer Center, Korea between 2000 and 2015 (n = 4,291) were followed up until February 2017. Differences in patient characteristics and outcomes were compared between chronological cohorts: cohort A (2000-2004, n = 1,157) vs. B (2005-2009, n = 1,678) vs. C (2010-2015, n = 1,456).

Results: The median age of the patient cohort was 57 years (range, 13-98 years), and male predominance was noted (81.6%). HBV infection was the most common etiology (74.8%). The proportion of patients diagnosed with good liver function and small tumors (<2 cm) increased significantly over time: 74.6%, 79.9%, and 87.4% for Child-Pugh class A (p<0.001) and 8.0%, 8.5%, and 12.0% for modified UICC stage I (p<0.001) in cohorts A, B, and C, respectively. Median overall survival improved significantly over time: 14.4 months (95% confidence interval [CI], 12.0-16.8 months), 22.9 months (95% CI, 20.3-25.5 months), and 53.6 months (95% CI, 45.7-61.5 months) in cohorts A, B, and C, respectively. HBV-related patients showed significantly improved survival (12.7 vs. 20.4 vs. 64.5 months, p<0.001) associated with the use of antiviral treatments (adjusted hazard ratio, 0.72; 95% CI, 0.64-0.80).

Conclusions: The survival of patients with HCC, especially HBV-related HCC, has improved significantly over time in Korea.

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Conflict of interest statement

The authors declare that they do not have anything to disclose or conflict of interest with respect to this manuscript.

Figures

Fig 1
Fig 1. Study design.
Fig 2
Fig 2
Survival of patients according to the subgroups in entire cohort (A), in patients with HBV etiology (B), and non-HBV etiology (C).
Fig 3
Fig 3. Proportion of patients who used nucleos(t)ide analogues (A) and the survival of patients according to the use of nucleos(t)ide analogues (B).
See this image and copyright information in PMC

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