Global patterns of hepatocellular carcinoma management from diagnosis to death: the BRIDGE Study
Joong-Won Park1,*, Minshan Chen2, Massimo Colombo3, Lewis R. Roberts4, Myron Schwartz5, Pei-Jer Chen6, Masatoshi Kudo7, Philip Johnson8, Samuel Wagner9, Lucinda S. Orsini10 andMorris Sherman11
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
Issue
Liver International
Volume 35, Issue 9, pages 2155–2166, September 2015
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1 Center for Liver Cancer, National Cancer Center, Goyang, Korea
2 Sun Yat-Sen University Cancer Center, Guangzhou, China
3 Policlinic IRCCS Maggiore Hospital, University of Milan, Milan, Italy
4 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
5 Mount Sinai Hospital, New York, NY, USA
6 Taiwan National University, Taipei, Taiwan
7 Kinki University School of Medicine, Osaka-Sayama, Osaka, Japan
8 Birmingham University, Birmingham, UK
9 Bristol-Myers Squibb, Princeton, NJ, USA
10 Bristol-Myers Squibb, Wallingford, CT, USA
11 University of Toronto, Toronto, ON, Canada
* Correspondence
Joong-Won Park, MD, PhD, Center for Liver Cancer, National Cancer Center, Korea, 323 Ilsan-ro, Ilsandong-gu, Goyang, Gyeonggi 410-769, South Korea
Tel: 82-31-920-1605
Fax: 82-31-920-2799
e-mail: [email protected]
The copyright line for this article was changed on 13 April 2015 after original online publication.
Hepatocellular carcinoma (HCC) is the second most common cause of cancer deaths worldwide. The global HCC BRIDGE study was a multiregional, large-scale, longitudinal cohort study undertaken to improve understanding of real-life management of patients with HCC, from diagnosis to death.
Methods
Data were collected retrospectively from January 2005 to September 2012 by chart reviews of eligible patients newly diagnosed with HCC at participating institutions.
Results
Forty-two sites in 14 countries contributed final data for 18 031 patients. Asia accounted for 67% of patients, Europe for 20% and North America for 13%. As expected, the most common risk factor was hepatitis C virus in North America, Europe and Japan, and hepatitis B virus in China, South Korea and Taiwan. The most common Barcelona Clinic Liver Cancer stage at diagnosis was C in North America, Europe, China and South Korea, and A in Taiwan and Japan. Across all stages, first HCC treatment was most frequently transarterial chemoembolization in North America, Europe, China and South Korea, percutaneous ethanol injection or radiofrequency ablation in Japan and resection in Taiwan. Survival from first HCC treatment varied significantly by region, with median overall survival not reached for Taiwan and 60, 33, 31, 24 and 23 months for Japan, North America, South Korea, Europe and China respectively (P < 0.0001).
Conclusions
Initial results from the BRIDGE study confirm previously reported regional trends in patient demographic characteristics and HCC risk factors, document the heterogeneity of treatment approaches across regions/countries and underscore the need for earlier HCC diagnosis worldwide.