Secular Trends of Clinical Characteristics and Survival of Hepatocellular Carcinoma in Taiwan from 2011 to 2019

Abstract

Hepatocellular carcinoma (HCC) is a major cause of cancer death in Taiwan, and in the past 30–40 years, Taiwan has been committed to its prevention and treatment. We aimed to investigate the secular trends of characteristics and the survival of HCC in recent decades after making increased efforts. Between 2011 and 2019, a total of 73,817 cases were enrolled from the TCR database. The overall male-to-female ratio was 7/3. The overall, male and female mean ages increased from 63.8 to 66.1 years, 62.0 to 64.3 years and 68.3 to 70.4 years, respectively. After dividing by viral etiologies and gender, the mean age showed increasing trends in all subgroups. The proportions of HBV-HCC, HCV-HCC, HBV+HCV-HCC and Non-HBV+non-HCV-HCC were 48.3%, 25.2%, 5.3% and 21.3% in males, compared with 25.5%, 48.6%, 5.3% and 20.5% in females, respectively. The 5-year survival rates of BCLC stages 0, A, B, C and D were 70%, 58%, 34%, 11% and 4%, respectively. The proportion of BCLC stage 0 increased from 6.2% to 11.3%. Multivariate analysis showed that being female, older age, diagnostic year, BCLC stages, hospital level, body mass index, smoking, alcohol consumption, AFP, Child–Pugh classification and HBV/HCV status were independent predictors for survival. In recent decades, the overall survival of HCC in Taiwan has been improving and might be partly associated with increased BCLC 0 and Child–Pugh A patients, while with the consequent age of patients increasing over time. The proportion of viral-related HCC is decreasing, while nonviral-related HCC is increasing.

Above-Standard Survival of Hepatocellular Carcinoma as the Final Outcome of Comprehensive Hepatology Care Programs in a Remote HCV-Endemic Area

“…Curative treatments became more widely available to HCC patients, generally improving prognosis [ 36 ]. In Taiwan, the 5-year survival rates of BCLC stages 0, A, B, C, and D were 70%, 58%, 34%, 11%, and 4%, respectively [ 11 ]. The median survival years of BCLC stages 0, A, B, C, and D were 9.7, 6.3, 2.7, 0.6, and 0.2 years, respectively [ 11 ].…”

“…In Taiwan, the 5-year survival rates of BCLC stages 0, A, B, C, and D were 70%, 58%, 34%, 11%, and 4%, respectively [ 11 ]. The median survival years of BCLC stages 0, A, B, C, and D were 9.7, 6.3, 2.7, 0.6, and 0.2 years, respectively [ 11 ]. The proportion of BCLC stage 0 patients increased from 6.2% to 11.3%.…”

“…The proportion of BCLC stage 0 patients increased from 6.2% to 11.3%. The survival rate significantly increased year-by-year from 2011 to 2019 [ 11 ].…”

“…Our cohorts’ median survival rate for patients in the B stage was 3.34 years. In Taiwan, the 5-year survival rates of BCLC stages 0 and A were 70% and the median survival rates of BCLC stage B patients were 2.7 years [ 11 ]. The expectations of the BCLC guideline 2022 for patients in stages 0/A and B are >5 and >2.5 years [ 9 ].…”

“…We conducted this retrospective study to evaluate the differences of HCC survival between screening and non-screening patient populations. We also compared the HCC survival result of our comprehensive hepatology care program for rural communities with the expectations of the updated BCLC guideline 2022 [ 9 , 11 ].…”