title: Clinical outcomes of a cohort series of patients with hepatocellular carcinoma in a hepatitis B virus-endemic area.
abstract: OBJECTIVE
  To evaluate the clinical outcomes of patients with hepatocellular carcinoma (HCC) and compare the findings with that of a previous cohort.
  
  
  METHODS
  Overall, 1972 HCC patients diagnosed and treated at the National Cancer Center, Korea between 2004 and 2009 were enrolled. The data of this cohort were compared with those of a previous cohort (2000-2003) from the same institution.
  
  
  RESULTS
  In all (mean age, 56.4 years; 1642 men), 74.6% was hepatitis B virus (HBV) positive, 81.6% were Child-Pugh (CP) class A, and 64.4% was Barcelona Clinic Liver Cancer (BCLC) stage C. The modified Union for International Cancer Control (mUICC) stage I, II, III, IVa, and IVb was found in 8.9%, 29.6%, 24.8%, 23.1%, and 13.6% patients, respectively. The most common initial treatment was transarterial chemotherapy (58.3%), followed by resection (18.6%). The 5-year survival rate of BCLC stage 0, A, B, and C were 79.6%, 67.2%, 33.9%, and 17.1%, respectively. The performance status, BCLC stage, mUICC stage, CP class, model for end-stage liver disease score, tumor characteristics, portal vein tumor invasion, and serum alpha-fetoprotein level proved to be independent prognostic variables. Overall survival in the present cohort was better than that in the previous cohort (hazard ratio, 0.829; 95% confidence interval, 0.754-0.912), especially for advanced HCC patients with HBV-positive status.
  
  
  CONCLUSIONS
  This cohort study provides valuable insights into the characteristics of HCC in Korean patients. Our findings may help develop clinical trials, treatment strategies, and prognosis systems for HCC patients in HBV-endemic areas.
authors: Center for Liver Cancer, National Cancer Center, Goyang, Korea.
authors: Hee-Won
authors: HW
authors: Kwak
authors: Joong-Won
authors: JW
authors: Park
authors: Byung-Ho
authors: BH
authors: Nam
authors: Ami
authors: A
authors: Yu
authors: Sang Myung
authors: SM
authors: Woo
authors: Tae Hyun
authors: TH
authors: Kim
authors: Seong Hoon
authors: SH
authors: Kim
authors: Young Hwan
authors: YH
authors: Koh
authors: Hyun Beom
authors: HB
authors: Kim
authors: Sang Jae
authors: SJ
authors: Park
authors: Woo Jin
authors: WJ
authors: Lee
authors: Eun Kyung
authors: EK
authors: Hong
authors: Chang-Min
authors: CM
authors: Kim
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology*; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D013534:Survival; D013997:Time Factors; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins
keywords: HBV-endemic area; cohort; hepatocellular carcinoma; survival outcome; temporal comparison