Survival analysis of 904 patients with hepatocellular carcinoma in a hepatitis B virus-endemic area.
OBJECTIVE
To investigate the clinical characteristics and survival outcomes of a large cohort of hepatocellular carcinoma (HCC) patients treated at a single institute in a hepatitis B virus (HBV)-endemic area.


METHODS
Between 2000 and 2003, 904 patients with HCC treated at our institute were enrolled, and followed until 2005.


RESULTS
The mean age of the patients was 56 years and 76.3% were HBV-positive. The 1-, 2-, 3-, and 4-year survival rates were 53.8%, 40.0%, 31.4%, and 25.7%, respectively. The 4-year survival rates for Child-Pugh class A patients treated by resection or transarterial chemoembolization (TACE) were 77.3% and 63.2% for those with modified International Union Against Cancer (UICC) stage I or II disease (P = 0.043), and 58.6% and 19.2% for those with modified UICC stage III disease (P < 0.001). In patients with Child-Pugh class A and stage IVa, the median survival times differed between TACE and chemotherapy treatments (6.9 vs 4.0 months, P = 0.003), whereas in patients with stage IVb there was no difference between treatments (8.5 vs 6.1 months, P = 0.173) Serum alpha-fetoprotein level, presence of portal vein tumor thrombosis, Child-Pugh class, tumor, node, and metastasis stage, and the number and type of HCC were all related to prognosis. Significant differences in survival curves were observed among the Japanese Integrated Staging scores.


CONCLUSIONS
The results of this study will be helpful in determining the survival outcomes and treatment strategies for HCC patients in HBV-endemic areas.
Park
Kyung Woo
KW
Center for Liver Cancer, National Cancer Center, Goyang, Republic of Korea.
Park
Joong-Won
JW
Choi
Jun Il
JI
Kim
Tae Hyun
TH
Kim
Seong Hoon
SH
Park
Hong Suk
HS
Lee
Woo Jin
WJ
Park
Sang Jae
SJ
Hong
Eun Kyung
EK
Kim
Chang-Min
CM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy / Q000821:virology; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D019353:Endemic Diseases; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006509:Hepatitis B / Q000150:complications / Q000453:epidemiology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007723:Korea / Q000453:epidemiology; D008113:Liver Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000628:therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology; D000509:alpha-Fetoproteins / Q000378:metabolism
C097353:AFP protein, human; D000970:Antineoplastic Agents; D000509:alpha-Fetoproteins