Incidence, mortality, and survival of liver cancer using Korea central cancer registry database: 1999-2019

Abstract

Backgrounds/aims: Historically, incidence and survival analysis and annual traits for primary liver cancer (LC) has not been investigated in a population-based study in Korea. The purpose of the current study is to determine incidence, survival rate of patients with primary LC in Korea.

Methods: We conducted a retrospective cohort study using Korea Central Cancer Registry based on the Korea National Cancer Incidence Database. Statistical analysis including crude rate and age-standadized rate (ASR) of incidence and mortality was performed for LC patients registered with C22 code in International Classification of Diseases, tenth revision from 1999 to 2019. Subgroup analysis was performed for hepatocellular carcinoma (HCC, C22.0) and intrahepatic cholangiocarcinoma (IHCC, C22.1).

Results: The crude incidence rate of HCC (21.0 to 22.8 per 100,000) and IHCC (2.3 to 5.6 per 100,000) increased in the observed period from 1999 to 2019. The ASR decreased in HCC (20.7 to 11.9 per 100,000) but remained unchanged in IHCC (2.4 to 2.7 per 100,000). The proportion of HCC patients diagnosed in early stages (localized or regional Surveillance, Epidemiology, and End Results or SEER stage) increased significantly over time. As expected, 5-yeat survival rate of HCC was greatly improved, reaching 42.4% in the period between 2013 and 2019. This trait was more prominent in localized SEER stage. On the other hand, the proportion of IHCC patients diagnosed in localized stage remained unchanged (22.9% between 2013 and 2019), although ASR and 5-year survival rate showed minor improvements.

Conclusions: A great improvement in survival rate was observed in patients with newly diagnosed HCCs. It was estimated to be due to an increase in early detection rate. On the contrary, detection rate of an early IHCC was stagnant with a minor improvement in prognosis.

Keywords: Hepatocellular carcinoma; Intrahepatic cholangiocarcinoma; Liver cancer; SEER stage.

Fig. 1

Overall annual cases age-standardized crude rates and male-to-female ratio of LC. (A) Overall annual cases of LC. (B) Age-standardized crude rates of LC. (C) Male-to-female ASR of LC. LC, liver cancer; HCC, hepatocellular carcinoma; IHCC, intrahepatic cholangiocarcinoma; ASR, age-standardized rate.

Fig. 2

Annual cases, CR, and ASR of incidence and mortality of HCC. (A) Annual cases and deaths of HCC. (B) CR and ASR of incidence and mortality of HCC. HCC, hepatocellular carcinoma; CR, crude rate; ASR, age-standardized rate.

Fig. 3

Stage, treatments, and survival of hepatocellular carcinoma (HCC). (A) SEER (Surveillance, Epidemiology, and End Results) stage of HCC. (B) First course of treatment for HCC. (C) Five-year survival rate of HCC by year, age, and SEER stage. (D) Five-year survival rate of HCC by SEER stage and treatments. Statistically significant (*p < 0.05; **p < 0.01).

Fig. 4

Annual cases, CR, and ASR of incidence and mortality of IHCC. (A) Annual cases by sex, new cases, and deaths of IHCC. (B) CR and aASR of incidence and mortality of IHCC. IHCC, intrahepatic cholangiocarcinoma; CR, crude rate; ASR, age-standardized rate.

Fig. 5

Stage, treatments, and survival of intrahepatic cholangiocarcinoma (IHCC). (A) SEER (Surveillance, Epidemiology, and End Results) stage of IHCC. (B) First course of treatment of IHCC. (C) Five-year survival rate of IHCC by year, age, and SEER stage. (D) Five-year survival rate of IHCC by SEER stage and treatments. Statistically significant (*p < 0.05; **p < 0.01).