Long-term trends and geographic variations in the survival of patients with hepatocellular carcinoma: analysis of 11,312 patients in Taiwan.
OBJECTIVE
The survival rates of patients with hepatocellular carcinoma (HCC) were investigated over the past 20 years to clarify the long-term survival trend.


METHODS
A total of 11 312 patients with HCC from seven medical centers from 1986 to 2002 were included. Survival was analyzed by correlating data with the national mortality databank.


RESULTS
Multivariate analysis showed that the following factors were associated with shorter survival: male sex, younger age, hepatitis B virus, earlier year of diagnosis, alpha fetoprotein higher than 400 ng/mL, alanine aminotransferase (ALT) higher than two times the upper normal limit, higher aspartate aminotransferase (AST)/ALT ratio, central or southern Taiwan residence, and rural areas residence. Patients diagnosed during 1998-2002 showed the highest survival rate, followed by patients diagnosed during 1994-1997, 1990-1993, and 1986-1989, respectively.


CONCLUSIONS
There are geographic variations in the survival rates of patients with HCC. Survival has been improving gradually over the past 20 years, probably due to earlier detection of HCC or to improved patient care.
Chen
Chien-Hung
CH
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Su
Wei-Wen
WW
Yang
Sheng-Shun
SS
Chang
Ting-Tsung
TT
Cheng
Ken-Sheng
KS
Lin
Hans Hsienhong
HH
Wu
Shun-Sheng
SS
Lee
Chuan-Mo
CM
Changchien
Chi-Sin
CS
Chen
Chien-Jen
CJ
Sheu
Jin-Chuan
JC
Chen
Ding-Shinn
DS
Lu
Sheng-Nan
SN
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors