Young Eun Chon, Han Ah Lee, Jun Sik Yoon, Jun Yong Park, Bo Hyun Kim, In Joon Lee, Suk Kyun Hong, Dong Hyeon Lee, Hyun-Joo Kong, Eunyang Kim, Young-Joo Won, Jeong-Hoon Lee
J Liver Cancer. 2020;20(2):135-147. Published online September 30, 2020
Background/Aim s: Considering the high prevalence and mortality of hepatocellular carcinoma (HCC) in Korea, accurate statistics for HCC are important. We evaluated the characteristics of Korean patients with newly diagnosed HCC.
Methods We retrospectively evaluated data from the Korean Primary Liver Cancer Registry (KPLCR). The baseline characteristics, treatment modalities, and overall survival (OS) of 4,572 patients with HCC registered in the KPLCR between 2012 and 2014 were investigated.
Results At the time of HCC diagnosis, the median age was 60.0 years, with male predominance (79.6%). Hepatitis B virus infection was the most common etiology (59.1%). The rates of Barcelona Clinic Liver Cancer (BCLC) stages 0, A, B, C, and D at diagnosis were 3.9%, 36.9%, 12.5%, 39.4%, and 7.3%, respectively. The proportion of very early or early stage HCC at diagnosis (BCLC stage 0 or A) in the 2012-2014 cohort was significantly lower than that in the 2008-2011 cohort (40.8% vs. 48.3%, P<0.001). Transarterial therapy (37.5%) was the most commonly performed initial treatment, followed by surgical resection (19.8%), best supportive care (19.1%), and local ablation (10.6%). The median OS was 2.9 years, and the 1-, 3-, and 5-year OS rates were 67.7%, 49.3% and 41.9%, respectively. The OS rate of the 2012-2014 cohort was significantly higher than that of the 2008-2011 cohort (log-rank, P<0.001).
Conclusions The OS of HCC patients registered in the KPLCR between 2012 and 2014 significantly improved. Nevertheless, as about half of the HCC patients were diagnosed at an advanced stage, vigorous and optimized HCC screening strategies should be implemented.
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J Liver Cancer. 2020;20(1):41-52. Published online March 31, 2020
Backgrounds/Aims Backgrounds/Aims: In Korea, hepatocellular carcinoma (HCC) is the sixth most common cancer and results in the second-highest cancer death rate among all cancers. We aimed to describe the characteristics of patients who were newly diagnosed with HCC in Korea between 2008 and 2011.
Methods The Korean Primary Liver Cancer Registry (KPLCR) is a random sample consisting of approximately 15% of patients with newly diagnosed primary liver cancer registered in the Korean Central Cancer Registry. We investigated the baseline characteristics, treatment modalities, and overall survival (OS) of patients with HCC registered in the KPLCR between 2008 and 2011.
Results A total of 6,083 patients were histologically or radiologically diagnosed with HCC. The hepatitis B virus was the predominant HCC etiology (72.0%). According to the Barcelona Clinic Liver Cancer (BCLC) staging system, stages 0, A, B, C, and D accounted for 8.6%, 39.7%, 11.5%, 33.8%, and 6.9%, respectively. Transarterial therapy (41.7%) was the most commonly performed initial treatment, followed by best supportive care (21.7%), surgical resection (16.7%), and local ablation therapies (10.6%). The overall rate of adherence to the BCLC treatment guideline was only 37.7%. The 1-, 3-, and 5-year OS rates were 65.6%, 46.2%, and 36.8%, respectively.
Conclusions Between 2008 and 2011, approximately half of patients with HCC (48.3%) were candidates for curative treatment (BCLC stage 0 or A), but one-third of patients (33.8%) had advanced HCC (BCLC stage C). Transarterial therapy was the most commonly conducted initial treatment and the 5-year OS rate was 36.8% in this period.
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Hepatocelluar carcinoma (HCC) is the most common primary liver cancer in the world and the most prevalent cancer among
patients liver cirrhosis. The management of HCC depends on tumor stage and the degree of liver dysfunction. Patients with
intermediate-stage HCC are ineligible for surgical or local ablative treatments. Current treatment guidelines recommend
trans-arterial chemoembolization (TACE) for intermediate stage of HCC. However, tumor recurrence after TACE is universal
and the survival benefit is relatively small. Hence, new strategies are needed to improve the outcome of HCC patients undergoing
TACE. Recently, the combination of target agents with TACE has shown promising overall survival in advanced HCC. It is
necessary to investigate new treat strategy how to increase treatment outcome of advanced HCC by new treat strategy.
Acute pancreatitis is a rare but severe postprocedural complication after transcatheter arterial chemoembolization (TACE) of
hepatocellular carcinoma with an incidence of 1.7-4%. The proposed mechanism of this complication is inadvertent
embolization through collateral vessels or regurgitation of chemotherapeutic agents to the arteries of other organs. Here, we
present a fatal necrotizing pancreatitis case which developed 10 days after TACE, caused by the regurgitation of the
chemotherapeutic agents to the pancreas during the procedure. The patient recovered with conservative care at first, but after
suffering from several times of recurrent pancreatitis, he died of peritoneal septic shock 5 months after the initial pancreatitis
attack.