Hepatocellular Carcinoma in Korea: an Analysis of the 2015 Korean Nationwide Cancer Registry

Abstract

Background/aims: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer-related death in Korea. This study evaluated the characteristics of Korean patients newly diagnosed with HCC in 2015.

Methods: Data from the Korean Primary Liver Cancer Registry (KPLCR), a representative sample of patients newly diagnosed with HCC in Korea, were analyzed. A total of 1,558 patients with HCC registered in the KPLCR in 2015 were investigated.

Results: The median age was 61.0 years (interquartile range, 54.0-70.0 years), and men accounted for 79.7% of the subjects. Hepatitis B virus infection was the most common underlying liver disease (58.1%). According to the Barcelona Clinic Liver Cancer (BCLC) staging system, stage 0, A, B, C, and D HCCs accounted for 14.2%, 31.5%, 7.6%, 39.0%, and 7.8% of patients, respectively. Transarterial therapy (32.1%) was the most commonly performed initial treatment, followed by surgical resection (23.2%), best supportive care (20.2%), and local ablation therapy (10.7%). Overall, 34.5% of patients were treated in accordance with the BCLC guidelines: 59.2% in stage 0/A, 48.4% in stage B, 18.1% in stage C, and 71.6% in stage D. The 1-, 3-, and 5-year OS rates were 67.1%, 50.9%, and 27.0%, respectively.

Conclusions: In 2015, approximately 45% of Korean HCC cases were diagnosed at a very early or early stage, and 35% of patients underwent potentially curative initial treatment. BCLC guidance was followed in 34.5% of patients; in patients with stage B or C disease, there was relatively low adherence.

Keywords: Epidemiology; Hepatitis B; Hepatocellular carcinoma; Korea; Survival.

Figure 1.

Initial treatment modality of the study population (A) and subgroups according to the Barcelona Clinic Liver Cancer (BCLC) stage 0 (B), stage A (C), stage B (D), stage C (E), and stage D (F). ^*Combination therapy was defined as a combined treatment with local ablation therapy and transarterial therapy; ^†Miscellaneous therapies were defined as unclassifiable treatment modalities (i.e., combination therapies other than transarterial therapy and local ablation therapy).

Figure 2.

Overall survival curves for Korean patients with hepatocellular carcinoma.

Figure 3.

Overall survival curves for the subgroups divided by the Child–Turcotte–Pugh (CTP) classes (A), modified Union for International Cancer Control stage (B), Barcelona Clinic Liver Cancer stage (C), and serum levels of alpha-fetoprotein (AFP) (D).