乙型肝炎病毒流行人口中肝细胞癌患者生存时间的改善。

StephenW

J Gastroenterol Hepatol. 2017 Jun 14. doi: 10.1111/jgh.13848. [Epub ahead of print]
Temporal Improvement in Survival of Patients with Hepatocellular Carcinoma in a Hepatitis B Virus-Endemic Population.Kim BH1,2, Lim YS2,3, Kim EY4, Kong HJ4, Won YJ4, Han S5, Park S6, Hwang JS2,7.
Author information
1Center for Liver Cancer, National Cancer Center, Goyang, Republic of Korea.2Korean Liver Cancer Association, Seoul, Republic of Korea.3Department of Gastroenterology, Liver center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.4Korea Central Cancer Registry, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Republic of Korea.5Department of Applied Statistics, Gachon University, Seongnam, Republic of Korea.6Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.7Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea.

AbstractBACKGROUND AND AIM: Over the past decade, the management of HCC and viral hepatitis has been improved. We explored survival trends and factors affecting survival of HCC in a hepatitis B virus (HBV)-endemic population.
METHODS: From 31521 and 38167 HCC registrants to the population-based national cancer registry in Korea, a hepatitis B virus (HBV)-endemic country, in the period of 2003-2005 and 2008-2010, we randomly sampled cohorts of 4515 and 4582 patients, respectively, for the investigation of clinical characteristics and survival.
RESULTS: Compared with Cohort 2003-2005, Cohort 2008-2010 had significantly better liver function (Child-Turcotte-Pugh class A, 64.2% vs. 71.6%; P<0.001) and had more advanced tumor stages (BCLC stage B-D, 45.8% vs. 50.4%; P<0.001). HBV was the predominant cause of HCC in both cohorts (62.5% vs. 62.2%; P=0.70). Cohort 2008-2010 had significantly better overall survival than Cohort 2003-2005 by age-adjusted univariate, multivariable, and propensity score-matched analyses (median survival time, 17.2 vs. 28.4 months; P<0.001). In a subcohort analysis, a consistently significant inter-cohort improvement in survival was observed only in patients with HBV-related HCC (median survival, 16.1 vs. 30.4 months; P<0.001). The annual number of patients with HCC receiving oral antiviral agents for HBV precipitously increased from 93 in 2005 to 28520 in 2010 in the country.
CONCLUSIONS: The consistent improvement in survival of patients with HCC was confined to HBV-related HCC subcohort over the last decade in a HBV-endemic population. The survival improvement coincided with the exponential use of oral antiviral agents for HBV in the patients.


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KEYWORDS: Hepatitis B virus; Hepatitis C virus; Hepatocellular carcinoma; Population; Registry

PMID:28612951DOI:10.1111/jgh.13848

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StephenW

G胃肠肝炎2017年6月14日。doi：10.1111 / jgh.13848。 [提前印刷]
乙型肝炎病毒流行人口中肝细胞癌患者生存时间的改善。
Kim BH1,2，Lim YS2,3，Kim EY4，Kong HJ4，Won YJ4，Han S5，Park S6，Hwang JS2,7。
作者信息

1
    韩国高阳国立癌症中心肝癌中心。
2
    韩国肝癌协会，韩国首尔。
3
    蔚山医科大学Asan医学中心肝脏中心消化内科，韩国首尔。
4
    韩国中央癌症登记处，韩国高阳国家癌症中心癌症登记监督处。
五
    大韩民国，贡南加拿大大学应用统计系。
6
    延安大学公共卫生研究科生物统计系，韩国首尔。
7
    大韩民国大邱科技大学医学部内科系。

抽象
背景与目的：

在过去十年中，肝癌和病毒性肝炎的治疗得到改善。我们探讨了影响乙型肝炎病毒（HBV）流行人口HCC存活率的生存趋势和因素。
方法：

从31521和38167名HCC注册人到2003 - 2005年和2008 - 2010年期间在韩国的基于人口的国家癌症登记处，乙型肝炎病毒（HBV）流行国家，我们随机抽取了4515例和4582例患者，分别用于临床特征和生存的调查。
结果：

与2003 - 2005年队伍相比，2008 - 2010年队伍肝功能明显好转（Child-Turcotte-Pugh A类，64.2％对71.6％; P <0.001），肿瘤分期更高（BCLC期BD，45.8％vs 50.4％; P <0.001）。两组患者HBV的主要原因是HBV（62.5％vs. 62.2％; P = 0.70）。 2008 - 2010年队伍年龄调整单变量，多变量和倾向得分匹配分析（中位数生存时间，17.2对28.4个月; P <0.001），总体生存期比2003-2005年队伍明显好转。在亚组分析中，只有HBV相关HCC患者才能观察到持续显着的生存期改善（中位生存期16.1比30.4个月; P <0.001）。 HCC接受乙肝口服抗病毒药物的年度数量急剧增加，从2005年的93个增加到2010年的28520个。
结论：

在过去十年中，HBV感染人群中HCC患者的生存率持续改善仅限于与HBV相关的HCC亚组。生存改善与患者乙型肝炎病毒口服抗病毒药物的指数使用吻合。

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关键词：

乙型肝炎病毒丙型肝炎病毒肝细胞癌;人口;注册处

结论：
    28612951
DOI：
    10.1111 / jgh.13848