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 |
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2021
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| Abstract | 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. |
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| AbstractList | 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. We sought to analyze the preferred treatment modality by age and liver function in South Korea. 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) , , and . 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 ( < 0.001), and the transarterial therapy rate significantly increased ( < 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 ( < 0.001). In CPC C, transarterial therapy and systemic therapy were attempted in 15.4% and 5.8% of patients, respectively. 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. We sought to analyze the preferred treatment modality by age and liver function in South Korea.BackgroundWe sought to analyze the preferred treatment modality by age and liver function in South Korea.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.MethodsThe 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.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.ResultsFor 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.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.ConclusionsAge 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. |
| Author | Jung, Young Kul Yoon, Won Sup Rim, Chai Hong Park, Sunmin |
| AuthorAffiliation | 1 Department of Radiation Oncology, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea 2 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea |
| AuthorAffiliation_xml | – name: 1 Department of Radiation Oncology, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea – name: 2 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Gyeonggi-do, Republic of Korea |
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| Copyright | Copyright © 2021 Sunmin Park et al. Copyright © 2021 Sunmin Park et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0 Copyright © 2021 Sunmin Park et al. 2021 |
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| Snippet | Background. We sought to analyze the preferred treatment modality by age and liver function in South Korea. Methods. The Korean Liver Cancer Study Group... Background . We sought to analyze the preferred treatment modality by age and liver function in South Korea. Methods . The Korean Liver Cancer Study Group... We sought to analyze the preferred treatment modality by age and liver function in South Korea. The Korean Liver Cancer Study Group randomly extracted the data... We sought to analyze the preferred treatment modality by age and liver function in South Korea.BackgroundWe sought to analyze the preferred treatment modality... |
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| SubjectTerms | 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 |
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| Title | Therapeutic Decision Making in Hepatocellular Carcinoma According to Age and Child–Pugh Class: A Nationwide Cohort Analysis in South Korea |
| URI | https://dx.doi.org/10.1155/2021/6640121 https://cir.nii.ac.jp/crid/1872835443051671680 https://www.ncbi.nlm.nih.gov/pubmed/33505941 https://www.proquest.com/docview/2478358502 https://www.proquest.com/docview/2482663046 https://pubmed.ncbi.nlm.nih.gov/PMC7811492 https://doaj.org/article/41df414eb10641e8bd8a9264244f8c7c |
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