Cause of death and cause-specific mortality for primary liver cancer in South Korea: A nationwide population-based study in hepatitis B virus-endemic area

Abstract

Introduction:Primary liver cancer is one of the leading causes of cancer mortality in the world. However, causes of death have not been studied in detail in patients with liver cancer. Materials and Methods:Causes of death and cause-specific mortality risks in patients with primary liver cancer, diagnosed during 2000-2016, were investigated using the nationwide population-based cancer registry data in Korea (n=231,338). The cumulative incidence function and Fine-Gray models were used to estimate the cause-specific mortality under the competing risks. Risks of non-cancer deaths relative to the general population were compared by standardized mortality ratios (SMR).Results: Among the 179,921 deaths from the total, 92.4%, 1.7%, and 6.0% died of primary liver cancer, cancer from other sites, and non-cancer illnesses. Proportionate mortality from liver cancer persisted high. The five-year competing risks probability of death from liver cancer varied by tumor stage from 42% to 94%, and it remained high after ten years postdiagnosis (61%-95%). Competing mortality from other causes has continuously increased.The most common non-cancer causes of death were underlying liver diseases (SMR=15.6, 95% CI: 15.1,16.1) and viral hepatitis (SMR=46.5, 95% CI: 43.9, 49.2), which demonstrated higher mortality risks relative to the Korean general population. Higher mortality risks of suicide (SMR=2.6, 95% CI: 2.4,2.8) also existed. A significant increase in the risks of both liver cancer and non-cancer deaths existed in the older age (P<0.0001). Conclusion:Patients with liver cancer are most likely to die from liver cancer and related liver disease, even ten years after the diagnosis, highlighting a need for specialized long-term follow-up care.

Incidence, mortality, and survival of liver cancer using Korea central cancer registry database: 1999-2019

“…In 2019, 2,551 deaths were witnessed (Fig. 4A, Supplementary Table 5, 6). IHCC was diagnosed predominantly in males, with male to female ASR ratio of 2.08 in period III.…”

“…However, this is far from the case of IHCC in Korea. The incidence of IHCC is still increasing with a stagnant early detection rate [ 6 ]. To further improve survival and reduce socioeconomic cost resulting from LC, understanding the current status of nationwide LC incidence and survival rates as well as changes in traits over the past decades is of a great importance.…”

Applications of molecular barcode sequencing for the detection of low‐frequency variants in circulating tumour DNA from hepatocellular carcinoma

“…1,2 The incidence and prevalence of HCC are both high, and affected patients have a poor prognosis and low rate of survival. [2][3][4] However, estimated survival is ≥5 years for patients diagnosed during early stages, as defined using the Barcelona Clinic Liver Cancer (BLCL) staging system. 2,5 Surveillance for early detection of HCC involves liver ultrasonography and serum markers, including α-fetoprotein (AFP) and prothrombin induced by vitamin K absence-II (PIVKA-II).…”

“…Chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections, heavy alcohol use, obesity, aflatoxin‐contaminated foodstuffs, smoking and type 2 diabetes are the main risk factors for HCC 1,2 . The incidence and prevalence of HCC are both high, and affected patients have a poor prognosis and low rate of survival 2–4 . However, estimated survival is ≥5 years for patients diagnosed during early stages, as defined using the Barcelona Clinic Liver Cancer (BLCL) staging system 2,5 …”

Risk factors for postoperative portal vein thrombosis in patients with hepatitis B liver cancer and its impact on mortality—a retrospective study

“…The incidence of hepatitis B in China is high. Long-term hepatitis B viral infection and inflammation can promote liver fibrosis and cirrhosis, and eventually leads to liver cancer (1)(2)(3). Surgery is the main treatment method for patients with liver cancer, but the incidence of postoperative complications such as postoperative portal vein thrombosis is higher in these patients and is reportedly as high as 3.4% (4).…”