Changes in real-life practice for hepatocellular carcinoma patients in the Republic of Korea over a 12-year period: A nationwide random sample study.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
28
05
2019
accepted:
25
09
2019
entrez:
18
10
2019
pubmed:
18
10
2019
medline:
17
3
2020
Statut:
epublish
Résumé
Comprehensive analyses through nationwide hepatocellular carcinoma (HCC) registries are important to understand health care issues. We assessed changes in real-life practice for HCC over a long time period. The Korean Liver Cancer Association and the Korean Central Cancer Registry jointly established the nationwide cohorts of newly diagnosed HCC patients between 2003 and 2005 and between 2008 and 2014. According to sorafenib reimbursement in the Republic of Korea (January 2011), patients were divided into early (E-Cohort: 2003~2010) and late (L-Cohort: 2011~2014) cohorts. L-Cohort (n = 4776) comprised patients with older age (60.8 vs. 58.3 years), higher proportions of patients with well-preserved liver function (75.6% vs. 68.2%) and non-viral etiologies (28.6% vs. 19.4%), and lower proportion of patients with Barcelona Clinic Liver Cancer [BCLC] 0~A stage (46.2% vs. 53.9%) than E-Cohort (n = 8203) (all p<0.05). Proportions of patients undergoing curative treatments were higher in L-Cohort than in E-Cohort (55.0% vs. 35.1%, 23.2 vs. 11.3%, and 17.3% vs. 9.6% in BCLC 0A, B, and C stages, respectively; all p<0.05). Accordingly, compared with that in E-Cohort, overall survival in L-Cohort significantly improved in patients with BCLC 0~A, B, and C stages (all p<0.05). As first-line treatment, 62.4% underwent locoregional treatments (LRTs), whereas only 9.7% received sorafenib, among BCLC stage C patients in L-Cohort. For the past 12 years, curative treatments became more widely available to BCLC 0~A, B, and C stage patients, generally improving prognosis. Despite sorafenib reimbursement, LRTs remain the mainstay of first-line treatment for BCLC C stage patients.
Sections du résumé
BACKGROUNDS & AIMS
Comprehensive analyses through nationwide hepatocellular carcinoma (HCC) registries are important to understand health care issues. We assessed changes in real-life practice for HCC over a long time period.
METHODS
The Korean Liver Cancer Association and the Korean Central Cancer Registry jointly established the nationwide cohorts of newly diagnosed HCC patients between 2003 and 2005 and between 2008 and 2014. According to sorafenib reimbursement in the Republic of Korea (January 2011), patients were divided into early (E-Cohort: 2003~2010) and late (L-Cohort: 2011~2014) cohorts.
RESULTS
L-Cohort (n = 4776) comprised patients with older age (60.8 vs. 58.3 years), higher proportions of patients with well-preserved liver function (75.6% vs. 68.2%) and non-viral etiologies (28.6% vs. 19.4%), and lower proportion of patients with Barcelona Clinic Liver Cancer [BCLC] 0~A stage (46.2% vs. 53.9%) than E-Cohort (n = 8203) (all p<0.05). Proportions of patients undergoing curative treatments were higher in L-Cohort than in E-Cohort (55.0% vs. 35.1%, 23.2 vs. 11.3%, and 17.3% vs. 9.6% in BCLC 0A, B, and C stages, respectively; all p<0.05). Accordingly, compared with that in E-Cohort, overall survival in L-Cohort significantly improved in patients with BCLC 0~A, B, and C stages (all p<0.05). As first-line treatment, 62.4% underwent locoregional treatments (LRTs), whereas only 9.7% received sorafenib, among BCLC stage C patients in L-Cohort.
CONCLUSIONS
For the past 12 years, curative treatments became more widely available to BCLC 0~A, B, and C stage patients, generally improving prognosis. Despite sorafenib reimbursement, LRTs remain the mainstay of first-line treatment for BCLC C stage patients.
Identifiants
pubmed: 31622424
doi: 10.1371/journal.pone.0223678
pii: PONE-D-19-10805
pmc: PMC6797085
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0223678Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Gut Liver. 2015 May 23;9(3):267-317
pubmed: 25918260
N Engl J Med. 2008 Jul 24;359(4):378-90
pubmed: 18650514
PLoS Med. 2014 Apr 01;11(4):e1001624
pubmed: 24691105
Radiology. 2018 Jan;286(1):29-48
pubmed: 29166245
PLoS One. 2013 Oct 14;8(10):e77240
pubmed: 24155932
Lancet. 2017 Jun 24;389(10088):2492-2502
pubmed: 28434648
Hepatology. 2018 Aug;68(2):723-750
pubmed: 29624699
Yonsei Med J. 2018 Oct;59(8):912-922
pubmed: 30187697
Liver Int. 2018 Sep;38(9):1624-1634
pubmed: 29791968
Aliment Pharmacol Ther. 2008 Nov 1;28(9):1067-77
pubmed: 18657133
Hepatology. 2017 Nov;66(5):1454-1463
pubmed: 28628942
Endocrinol Metab (Seoul). 2015 Jun;30(2):142-6
pubmed: 26194073
Liver Cancer. 2017 Nov;6(4):360-374
pubmed: 29234639
Vaccine. 1990 Mar;8 Suppl:S95-9
pubmed: 2139290
Clin Mol Hepatol. 2018 Jun;24(2):114-134
pubmed: 29439305
J Clin Gastroenterol. 2017 Oct;51(9):845-849
pubmed: 28877082
J Hepatol. 2012 Apr;56(4):908-43
pubmed: 22424438
Lancet. 2018 Mar 24;391(10126):1163-1173
pubmed: 29433850
World J Gastroenterol. 2015 Apr 7;21(13):3826-42
pubmed: 25852267
Korean J Hepatol. 2004 Jun;10(2):88-98
pubmed: 15218342
JAMA Oncol. 2018 May 1;4(5):661-669
pubmed: 29543938
J Gastroenterol Hepatol. 2018 Feb;33(2):475-483
pubmed: 28612951
Hepatology. 2018 Jan;67(1):358-380
pubmed: 28130846
J Gastroenterol Hepatol. 2016 Feb;31(2):442-9
pubmed: 26259976
Yonsei Med J. 2017 Sep;58(5):899-909
pubmed: 28792132
N Engl J Med. 2011 Sep 22;365(12):1118-27
pubmed: 21992124
Cancer Res Treat. 2017 Oct;49(4):1164-1169
pubmed: 28231425
Nat Rev Gastroenterol Hepatol. 2010 Aug;7(8):448-58
pubmed: 20628345
J Clin Oncol. 2002 Nov 15;20(22):4459-65
pubmed: 12431969
Hepatology. 2011 Mar;53(3):1020-2
pubmed: 21374666
Clin Mol Hepatol. 2019 Mar;25(1):1-11
pubmed: 30086613
Lancet. 2003 Dec 6;362(9399):1907-17
pubmed: 14667750
Clin Mol Hepatol. 2018 Mar;24(1):1-9
pubmed: 29249129