title: Changed clinical aspects of primary liver cancer in China during the past 30 years.
abstract: BACKGROUND
  Primary liver cancer (PLC) is one of the most frequently seen tumors in China. Thirty years ago, patients with PLC were often detected at relatively late stage, with a palpable mass or marked clinical symptoms and poor prognosis. In the past 30 years, the diagnosis and treatment of PLC have been greatly improved with better prognosis.
  
  
  METHODS
  In order to study the changes of PLC during the 30 years, the clinical data of 3250 patients with PLC from 10 medical institutions of China were collected, analyzed, and compared with those of 3254 PLC patients before the 30 years.
  
  
  RESULTS
  In the 3250 patients aged 1-80 years, with an average age of 49.1 years, the male to female ratio (2.3:1) was lower than that before the 30 years. 73.5% of the 3250 patients sought medical advice within 3 months after the onset of the disease in contrast to 63.8% before the 30 years. Compared with those patients before the 30 years the symptoms and signs were alleviated generally. The HBsAg positive rate was 81.0%, but the HCV-Ab positive rate was 13.2%. The AFP level in 75% of patients was elevated, but in the remaining 25% was normal. 1912 patients (58.8%) were confirmed pathologically. Among them 1755 patients (91.8%) had hepatocellular carcinoma. The overall resection rate was 46.3%. Those who had early, middle, late stage carcinoma accounted for 29.9%, 51.5%, and 18.6% respectively in contrast to 0.4%, 47.0%, and 52.6% reported before the 30 years. The 1-, 3-, 5-year survival rates of the patients were 66.1%, 39.7%, and 32.5% respectively, whereas 93.5%, 70.1%, and 59.1% for the early stage patients, and 65.3%, 30.5%, and 23.5% for the middle stage patients. The half and 1-year survival rates of the late stage patients were 52.5%, and 14.7%, respectively.
  
  
  CONCLUSIONS
  Comparison with the clinical data before and after the 30 years show that PLC can be diagnosed early. More PLC patients tend to undergo resection while receiving a better conservative treatment, which ensures a prognosis.
authors.affiliation: Liver Cancer Institute & Zhongshan Hospital, Fudan University, Shanghai 200032, China. bhyang@zshospital. net
authors.forename: Bing-Hui
authors.initials: BH
authors.lastname: Yang
authors.forename: Jing-Lin
authors.initials: JL
authors.lastname: Xia
authors.forename: Li-Wen
authors.initials: LW
authors.lastname: Huang
authors.forename: Zhao-You
authors.initials: ZY
authors.lastname: Tang
authors.forename: Ming-Shan
authors.initials: MS
authors.lastname: Chen
authors.forename: Jin-Qing
authors.initials: JQ
authors.lastname: Li
authors.forename: An-Min
authors.initials: AM
authors.lastname: Liang
authors.forename: Qin-Guo
authors.initials: QG
authors.lastname: Mo
authors.forename: Hui-Shan
authors.initials: HS
authors.lastname: Lu
authors.forename: Chao-Liu
authors.initials: CL
authors.lastname: Dai
authors.forename: Lu-Nan
authors.initials: LN
authors.lastname: Yan
authors.forename: Zhi-Jian
authors.initials: ZJ
authors.lastname: Yu
authors.forename: Rong-Sheng
authors.initials: RS
authors.lastname: Rao
authors.forename: Le-Qun
authors.initials: LQ
authors.lastname: Li
authors.forename: Zhi-Xiong
authors.initials: ZX
authors.lastname: Su
authors.forename: Zhuang-Wei
authors.initials: ZW
authors.lastname: Fang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D006801:Humans; D007223:Infant; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome