Continuous Improvement of Survival Outcomes of Resection of Hepatocellular Carcinoma

Fan, Sheung Tat; Lo, Chung Mau; Poon, Ronnie Tung Ping; Yeung, Chun; Liu, Chi Leung; Yuen, WK; Lam, Chi‐Ming; Ng, Kelvin K. C.; Chan, See Ching

doi:10.1097/sla.0b013e3182111195

Cited by 329 publications

(268 citation statements)

References 24 publications

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“…As a result, patient survival significantly increased in the later era, which is a reflection of the various factors mentioned above. Other studies have also observed similar trends in survival 34, 37, 45, 46. Despite demonstrating a significant improvement of survival over time, the median survival of 18.6 months in the later era still seems rather low.…”

Section: Discussionsupporting

confidence: 58%

Deciphering the epidemiology of hepatocellular carcinoma through the passage of time: A study of 1,401 patients across 3 decades

Goh

Chang

et al. 2017

Hepatology Communications

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Hepatocellular carcinoma (HCC) is one of the most common and lethal cancers globally. With advances in therapy for chronic viral hepatitis, changing social circumstances, and increasing practice of HCC surveillance, the epidemiology of HCC is expected to change over time. We explored the temporal trends in HCC in Singapore, a multiethnic Asian country, over the last 3 decades. Patients with HCC were prospectively enrolled and stratified into two cohorts (C1, 1988‐2002; C2, 2003‐2016). Patient and tumor characteristics, management, and survival were compared between the two cohorts, and a survival census was performed on October 31, 2015. There were 1,401 patients, and the mean age at diagnosis of HCC for C1 and C2 was 60.1 and 63.5 years, respectively. Male patient preponderance decreased significantly, with the male to female ratio falling from 5.2:1 to 3.9:1 between C1 and C2. Hepatitis B, although still the predominant risk factor for HCC, showed a significant decline from C1 to C2 (76.5% to 68.2%), while the nonviral etiology increased significantly over the same period (14.4% versus 25.0%, respectively). Significantly more patients in C2 than C1 were diagnosed through surveillance (39.2% versus 11.3%, respectively) and had better physical performance (Eastern Cooperative Oncology Group 0, 62.1% versus 20.4%, respectively). While Child‐Pugh status was comparable, significantly more patients in C2 than C1 had early stage disease (Barcelona Clinic Liver Cancer 0‐A, 39.5% versus 7.4%, respectively), which translated into significantly higher median survival (18.6 months versus 3.8 months, respectively). Conclusion: Over the past 3 decades, hepatitis B‐related HCC has been decreasing while HCC due to nonviral etiology has been increasing significantly. Surveillance to diagnose early stage HCC is important in improving the outcome of HCC. (Hepatology Communications 2017;1:564–571)

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Section: Discussionsupporting

confidence: 58%

Deciphering the epidemiology of hepatocellular carcinoma through the passage of time: A study of 1,401 patients across 3 decades

Goh

Chang

et al. 2017

Hepatology Communications

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“…Surgery, tumor ablation, and liver transplantation are the main potentially curative treatments for HCC. However, tumor recurrence rate is very high after liver resection and tumor ablation, which is a major problem affecting long term survival (4,5). Various postoperative interventions, such as adjuvant therapy with interferon, Vitamin E or K2, or I 131 , are used to reduce the incidence of tumor recurrence after curative treatment (6,7).…”

Section: Introductionmentioning

confidence: 99%

Adjuvant sorafenib reduced mortality and prolonged overall survival and post-recurrence survival in hepatocellular carcinoma patients after curative resection: A single-center experience

Zhang

Zhao

Wei

et al. 2014

BST

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“…20 This form of treatment should be reconsidered because over the last 20 years, there has been a continuous improvement in survival after HCC resection, even in older patients. 21 A tumor that is resectable must be present together with adequate functional liver reserve for sustaining life (found mostly in patients with Child-Pugh status A but sometimes in patients with Child-Pugh status B); this makes this treatment subset of elderly patients with HCC even smaller than the other subgroups. 22 There is evidence that this subgroup may be increasing in some countries.…”

Section: See Article On Page 423mentioning

confidence: 99%

Treatment of an elderly patient with hepatocellular carcinoma: Counseling from the patient's point of view

Perkins

2012

Liver Transpl

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Continuous Improvement of Survival Outcomes of Resection of Hepatocellular Carcinoma

Abstract: A continuous improvement of survival outcomes after hepatectomy for HCC was achieved in the past 20 years even in patients with advanced diseases. Hepatectomy remains the treatment of choice for resectable HCC in a predominantly hepatitis B virus-based Asian population.

Cited by 329 publications

References 24 publications

Deciphering the epidemiology of hepatocellular carcinoma through the passage of time: A study of 1,401 patients across 3 decades

Deciphering the epidemiology of hepatocellular carcinoma through the passage of time: A study of 1,401 patients across 3 decades

Adjuvant sorafenib reduced mortality and prolonged overall survival and post-recurrence survival in hepatocellular carcinoma patients after curative resection: A single-center experience

Treatment of an elderly patient with hepatocellular carcinoma: Counseling from the patient's point of view

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