Hepatocellular Carcinoma in Korea between 2012 and 2014: an Analysis of Data from the Korean Nationwide Cancer Registry

Abstract

Background/aims: Considering the high prevalence and mortality of hepatocellular carcinoma (HCC) in Korea, accurate statistics for HCC are important. We evaluated the characteristics of Korean patients with newly diagnosed HCC.

Methods: We retrospectively evaluated data from the Korean Primary Liver Cancer Registry (KPLCR). The baseline characteristics, treatment modalities, and overall survival (OS) of 4,572 patients with HCC registered in the KPLCR between 2012 and 2014 were investigated.

Results: At the time of HCC diagnosis, the median age was 60.0 years, with male predominance (79.6%). Hepatitis B virus infection was the most common etiology (59.1%). The rates of Barcelona Clinic Liver Cancer (BCLC) stages 0, A, B, C, and D at diagnosis were 3.9%, 36.9%, 12.5%, 39.4%, and 7.3%, respectively. The proportion of very early or early stage HCC at diagnosis (BCLC stage 0 or A) in the 2012-2014 cohort was significantly lower than that in the 2008-2011 cohort (40.8% vs. 48.3%, P<0.001). Transarterial therapy (37.5%) was the most commonly performed initial treatment, followed by surgical resection (19.8%), best supportive care (19.1%), and local ablation (10.6%). The median OS was 2.9 years, and the 1-, 3-, and 5-year OS rates were 67.7%, 49.3% and 41.9%, respectively. The OS rate of the 2012-2014 cohort was significantly higher than that of the 2008-2011 cohort (log-rank, P<0.001).

Conclusions: The OS of HCC patients registered in the KPLCR between 2012 and 2014 significantly improved. Nevertheless, as about half of the HCC patients were diagnosed at an advanced stage, vigorous and optimized HCC screening strategies should be implemented.

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

Figure 1

Initial treatment modalities of the study population (A) and subgroups according to the Barcelona Clinic Liver Cancer (BCLC) stage (B), stage A (C), stage B (D), stage C (E), and stage D (F). ^*Combination therapy was defined as combined treatment with local ablation 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 in 2012–2014, 2008–2011, and 2003–2005. HR, hazard ratio; CI, confidence interval.

Figure 3

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