title: Clinical features and prognosis of hepatocellular carcinoma in Mongolia: a multicentre study.
abstract: OBJECTIVE
  Hepatocellular carcinoma (HCC) is the most common cancer in Mongolia. We aimed to investigate the clinical features, therapeutic modalities, overall survival and prognostic factors for Mongolian patients with HCC.
  
  
  METHODS
  One hundred ninety-five patients with HCC were consecutively enroled in our study.
  
  
  RESULTS
  The mean age was 61.7 years. The most common etiology for HCC was HCV infection (n = 89, 45.6%), followed by HBV infection (n = 67, 34.4%). The mean tumor diameter was 6.0 ± 2.6 cm. Only 29 (14.9%) patients had a single lesion, while 39 (20.2%) had >3 lesions. Extrahepatic metastasis to lung (n = 23), bone (n = 10) and lymph node (n = 3) were detected in 36 (18.5%) patients. Most patients had advanced HCC-88 (45.1%) in stage III and 57 (29.2%) in stage IV. Surgical resection was performed in 27 (13.8%) patients, RFA in 23 (11.8%) and TACE in 107 (54.9%). When all the patients were categorized as 'treated' (n = 156) and 'not treated' (n = 39), the 3-year survival was significantly lower in the 'not treated' group than in the 'treated' group (11 vs. 0%, P < 0.001). Tumor diameter (<3 cm vs. ≥3 cm), extrahepatic metastasis, TNM stage (I/II vs. III/IV) and treatment (or supportive care) were selected as independent predictors for survival.
  
  
  CONCLUSIONS
  High proportion of patients with HCC in Mongolia is diagnosed at an advanced stage and survival of these patients is lower compared to other countries. A surveillance system and referral policy for high-risk groups should be urgently established and implemented in Mongolia.
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, South Korea.|Department of Infectious Diseases, Health Sciences University, Ulaanbaatar, Mongolia.|Mongolian Association for the Study of Liver Diseases, Ulaanbaatar, Mongolia.|Liver Cirrhosis Clinical Research Center, Seoul, South Korea.
authors.forename: Oidov
authors.initials: O
authors.lastname: Baatarkhuu
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, South Korea.|Liver Cirrhosis Clinical Research Center, Seoul, South Korea.
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.affiliation: Mongolian Academy of Medical Science, Ulaanbaatar, Mongolia.
authors.forename: Pagbajabyn
authors.initials: P
authors.lastname: Nymadawa
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, South Korea.|Liver Cirrhosis Clinical Research Center, Seoul, South Korea.
authors.forename: Seung Up
authors.initials: SU
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, South Korea.|Mongolian Academy of Medical Science, Ulaanbaatar, Mongolia.|Liver Cirrhosis Clinical Research Center, Seoul, South Korea.|Brain Korea 21 Project for Medical Sciences, Seoul, South Korea.
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
authors.affiliation: Mongolian Association for the Study of Liver Diseases, Ulaanbaatar, Mongolia.
authors.forename: Jazag
authors.initials: J
authors.lastname: Amarsanaa
authors.affiliation: Department of Radiology, Health Sciences University, Ulaanbaatar, Mongolia.
authors.forename: Dagvasumberel
authors.initials: D
authors.lastname: Gonchigsuren
authors.affiliation: Department of Surgery, National Cancer Center, Ulaanbaatar, Mongolia.
authors.forename: Ravjir
authors.initials: R
authors.lastname: Sanduijav
authors.affiliation: Department of Radiology, General Hospital #3, Ulaanbaatar, Mongolia.
authors.forename: Zundui
authors.initials: Z
authors.lastname: Lkhagvasuren
authors.affiliation: Department of Infectious Diseases, Health Sciences University, Ulaanbaatar, Mongolia.
authors.forename: Naran
authors.initials: N
authors.lastname: Khorolsuren
authors.affiliation: Department of Infectious Diseases, Health Sciences University, Ulaanbaatar, Mongolia.
authors.forename: Ravjir
authors.initials: R
authors.lastname: Oyungerel
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, South Korea. ahnsh@yuhs.ac.|Liver Cirrhosis Clinical Research Center, Seoul, South Korea. ahnsh@yuhs.ac.|Brain Korea 21 Project for Medical Sciences, Seoul, South Korea. ahnsh@yuhs.ac.
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
keywords: Hepatocellular carcinoma; Mongolia; Survival