Improving prognosis for patients with hepatocellular carcinoma in Ireland 1994-2008.
OBJECTIVE
The incidence of hepatocellular carcinoma (HCC) is increasing in low-prevalence countries such as the USA, UK and Ireland. Over the past two decades, diagnostic techniques have improved and new treatments have been introduced. The aim of this study was to determine whether there has been an impact on hepatoma mortality in Ireland.


METHODS
Anonymized cancer registration data from the National Cancer Registry of Ireland were used to investigate patient characteristics and trends in treatment and survival for Irish patients diagnosed with histologically confirmed HCC between 1994 and 2008. Analyses were carried out according to sex, age, stage of disease treatment received and period of incidence.


RESULTS
The incidence of HCC in Ireland increased steadily from 1994 to 2008. The median overall survival was 580 days for the entire cohort, with 1, 2, 3 and 5-year survivals of 56, 46, 39 and 36%, respectively. One-year cause-specific survival improved from 38% during 1994-1998, to 51% during 1999-2002 and to 66% during 2003-2007. Five-year cause-specific survival also improved over time from 19 to 34 to 38%, respectively. Surgery was associated with 1, 2, 3 and 5-year survivals of 92, 82, 78 and 78%, respectively.


CONCLUSIONS
This is the first population-based report of incidence, treatment patterns and outcomes of HCC in Ireland. Prognosis improved over time in this biopsy-proven cohort of patients with HCC. This improvement in survival seemed to be largely because of the effect of surgical interventions.
aSchool of Medicine, Trinity College Dublin bLiver Unit, St Vincent's University Hospital, Dublin cNational Cancer Registry Ireland, Cork, Ireland.
Caroline
C
Gaynor
Masood
M
Iqbal
Harry
H
Comber
Sandra
S
Deady
P Aiden
PA
McCormick
D017677:Age Distribution; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D016461:Chemoembolization, Therapeutic / Q000639:trends; D005260:Female; D006498:Hepatectomy / Q000639:trends; D006801:Humans; D015994:Incidence; D007494:Ireland / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D017678:Sex Distribution; D015996:Survival Rate
D000970:Antineoplastic Agents