Therapeutic Decision Making in Hepatocellular Carcinoma According to Age and Child–Pugh Class: A Nationwide Cohort Analysis in South Korea

Background. We sought to analyze the preferred treatment modality by age and liver function in South Korea. Methods. The Korean Liver Cancer Study Group randomly extracted the data of patients with hepatocellular carcinoma (HCC) enrolled in the Korean Central Cancer Registry from 2008 to 2014 from a...

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Veröffentlicht in:Canadian Journal of Gastroenterology and Hepatology Jg. 2021; H. 1; S. 1 - 7
Hauptverfasser: Park, Sunmin, Rim, Chai Hong, Jung, Young Kul, Yoon, Won Sup
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Egypt Hindawi 2021
Hindawi Limited
John Wiley & Sons, Inc
Wiley
Schlagworte:
Ablation
Age
Cancer therapies
Carcinoma, Hepatocellular
Carcinoma, Hepatocellular - epidemiology
Carcinoma, Hepatocellular - therapy
Chemotherapy
Cohort analysis
Cohort Studies
Decision Making
Diseases of the digestive system. Gastroenterology
Hepatitis
Humans
Liver cancer
Liver Neoplasms
Liver Neoplasms - therapy
Metastasis
Patients
Portal Vein
Radiation therapy
RC799-869
Republic of Korea
Retrospective Studies
Thrombosis
Treatment Outcome
Tumors
Veins & arteries
Republic of Korea
South Korea
ISSN:2291-2789, 2291-2797, 2291-2797
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Zusammenfassung:Background. We sought to analyze the preferred treatment modality by age and liver function in South Korea. Methods. The Korean Liver Cancer Study Group randomly extracted the data of patients with hepatocellular carcinoma (HCC) enrolled in the Korean Central Cancer Registry from 2008 to 2014 from approximately 50 hospitals nationwide. After excluding distant and lymphatic metastases, the treatment preference for patients with a single lesion (excluding PVT (portal vein thrombosis), hepatic vessels, and bile duct invasion) and with PVT was evaluated in 7559 patients. Patients were grouped by age, and baseline liver function was divided based on the Child–Pugh class (CPC) A, B, and C. Results. For a single HCC, the majority of patients selected transarterial therapy as the initial treatment, followed by surgical resection and local ablative therapy. The surgical resection rate decreased significantly with age (p<0.001), and the transarterial therapy rate significantly increased (p<0.001). For CPC C, liver transplantation was significantly increased to 11.5%, and 36.3% of patients received no treatment. In HCC with PVT, the transarterial therapy rate was the highest, followed by the rate of abandonment of treatment. The proportion of no treatment significantly increased with age (p<0.001). In CPC C, transarterial therapy and systemic therapy were attempted in 15.4% and 5.8% of patients, respectively. Conclusions. Age and liver function have a significant impact on the therapeutic decision-making of HCC patients in Korea. In unfavorable conditions, surgical resection was less favored in patients with single tumors, and no treatment was preferred in patients with PVT.
Bibliographie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Academic Editor: Alessandro Granito
ISSN:2291-2789
2291-2797
2291-2797
DOI:10.1155/2021/6640121