Clinical characteristics and prognosis of Korean patients with hepatocellular carcinoma with respect to etiology

Jang, Wonjoon; Lee, Hye Won; Lee, Jae Seung; Kim, Beom Kyung; Kim, Seung Up; Park, Jun Yong; Ahn, Sang Hoon; Kim, D. Y.

doi:10.17998/jlc.2022.09.18

Cited by 10 publications

(11 citation statements)

References 29 publications

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“…Although patients with CHB exhibited higher medical costs compared to the control group, the majority of these costs demonstrated a significant surge following the development of decompensated cirrhosis or HCC. 28 Given the recent surge in the use of costly antiviral medications, which often require long-term administration, there is a potential for further escalation in medication costs. However, considering the significant reduction in the incidence of HCC and complications related to cirrhosis due to the use of these drugs, it can be concluded that the active use of antiviral medications is cost-effective when considering the overall disease progression.…”

Section: Discussionmentioning

confidence: 99%

The Epidemiology of Hepatitis B Virus Infection in Korea: 15-Year Analysis

Kim,

Yoo,

Chang

et al. 2024

J Korean Med Sci

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Background The purpose of this study is to investigate the epidemiological changes in chronic hepatitis B (CHB) and assess the impact of coronavirus disease 2019 (COVID-19) over the past 15 years in a region endemic to hepatitis B virus (HBV). Methods National Health Insurance Service claims data of hepatitis B patients spanning from 2007 to 2021 was utilized. To compare the characteristics of the hepatitis B group, a control group adjusted for age and gender through propensity score matching analysis was established. Results The number of patients with CHB has consistently increased over the past 15 years. The average age of the CHB patient group has shown a yearly rise, while the prevalence of male dominance has gradually diminished. The proportions of hepatocellular carcinoma, liver cirrhosis, and decompensation have exhibited a declining pattern, whereas the proportion of liver transplants has continuously risen. Patients with CHB have demonstrated significantly higher medical and medication costs compared to the control group. Moreover, patients with CHB have shown a higher prevalence of comorbidities along with a significantly higher rate of concomitant medication usage. During the COVID period, the HBV group experienced a substantial decrease in the number of outpatient visits and overall medical costs compared to the control group. Conclusion The epidemiology of CHB has undergone significant changes over the past 15 years, encompassing shifts in prevalence, severity, medical costs, and comorbidities. Furthermore, the impact of COVID-19 has been observed to decrease healthcare utilization among patients with CHB when compared to controls.

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Section: Discussionmentioning

confidence: 99%

The Epidemiology of Hepatitis B Virus Infection in Korea: 15-Year Analysis

Kim,

Yoo,

Chang

et al. 2024

J Korean Med Sci

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“…On the other hand, in the case of liver cancer, the majority causes are hepatis B (74%) and C (9%) viral related, while toxin- related cases are very rare in Korea. 23 If NDMA acted as a carcinogenesis enhancer, there could make a significantly higher risk in the prevalent liver cancer in Korea. However, this study did not find such an effect, suggesting that NDMA is more likely to function as a direct carcinogen rather than a carcinogenesis enhancing function.…”

Section: Discussionmentioning

confidence: 99%

The Medical Impact of Emergent Banning of N-nitrosodimethylamine (NDMA)- contaminated Antihypertensive Drug: A nationwide longitudinal cohort study

Ahn,

Won,

Park

et al. 2023

Preprint

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OBJECTIVETo study the association of NDMA-contaminated generic valsartan with cancer incidence.DESIGNNationwide longitudinal observational cohort study.SETTINGClaims data from the National Health Insurance Service of South Korea was analyzed using 1:1:1 pairwise propensity score matching (PSM) of NDMA-uncontaminated original, NDMA-contaminated generic, and initially-suspended-but-finally confirmed as NDMA-uncontaminated generic valsartan user-groups. Time-dependent Cox models and dose- response evaluation were used to evaluate carcinogenicity.PARTICIPANTSA total of 3,231,212 participants with satisfactory minimal adherence, followed up from January 1, 2013 until December 31, 2020.INTERVENTIONSAt least one tablet of valsartan.MAIN OUTCOME MEASURESThe primary outcome was primary cancer incidence and secondary outcome was 12 prevalent organ-specific cancer incidences. All-cause and cardiovascular mortality risks were estimated before and after valsartan withdrawal.RESULTSAmong participants (mean [standard deviation] age 59.5 [13.1] years; male, 53.5%), new users had adjusted hazard ratios and 95% confidence intervals (CI) of 1.069 (1.054 to 1.085) and 1.142 (1.100 to 1.186) for any cancer in the NDMA-exposed period (versus NDMA-unexposed) before and after 1:1:1 PSM, respectively. Regardless of PSM, lung and prostate cancer risks increased significantly during the NDMA-exposed period whereas, post-PSM, cancer risk did not increase in the eventually-NDMA-uncontaminated group, even in new users. All-cause and cardiovascular mortality did not differ significantly with NDMA exposure before and after emergent banning.CONCLUSIONSNDMA-contaminated valsartan increased cancer risk, especially of lung and prostate cancers. All-cause and cardiovascular mortality did not evidently increase following banning. This supports emergent health-policy action against potentially carcinogenic drugs.

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“…[4] Globally, 15%-27% of patients awaiting LT die before transplantation. [7,8] In South Korea, only 2% of patients on the LT waitlist are expected to receive a deceased donor LT. [9,10] Because of the lack of donors, every country has allocation systems to objectively determine patients with poor prognosis without transplantation. Previously, various methods were used as an allocation system, and a representative example is the Child-Pugh score.…”

Section: Introductionmentioning

confidence: 99%

“…Globally, 15%–27% of patients awaiting LT die before transplantation 7,8 . In South Korea, only 2% of patients on the LT waitlist are expected to receive a deceased donor LT 9,10 …”

Section: Introductionmentioning

confidence: 99%

Validation of MELD 3.0 scoring system in East Asian patients with cirrhosis awaiting liver transplantation

Yoo

Chang²,

Moon

et al. 2023

Liver Transplantation

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Recently, a new predictive model that jointly considers the Model of End-stage Liver Disease (MELD) 3.0 and albumin has been proposed. This study investigated the performance of the MELD 3.0 score in predicting the 3-month survival of East Asian patients with cirrhosis compared with the other MELD-based scores. Validation was performed with the retrospective data of 2153 patients in South Korea who were listed for liver transplantation (LT). Discrimination and calibration analyses were performed using the MELD-based scores as an independent variable. On average, patients had the original MELD score of 18.70 ± 9.65. Alcohol (39.99%) and chronic HBV (38.55%) were the 2 main etiologies. The MELD 3.0 with albumin showed slightly better discrimination [c-index = 0.738, incremental AUC (iAUC) = 0.719] compared with the MELD 3.0 without albumin (c-index = 0.737, iAUC = 0.715), MELD-Na (c-index = 0.730, iAUC = 0.707), or the original MELD (c-index = 0.718, iAUC = 0.687) for predicting 3-month survival but not significantly different compared with prior models. Likewise, in the stratified analysis according to the strata of MELD, although the performance of MELD 3.0 was better throughout all the MELD strata than MELD original, there was no statistical difference in performance. The MELD 3.0 with albumin reclassified 22.61% of cases classified by the original MELD to higher MELD score categories, and there was no significant difference in the reclassification rate between males and females. The predictive power of the MELD-based system is lower in Asian populations than in western countries. Nonetheless, the MELD 3.0 score with albumin was significantly better in predicting the short-term prognosis of East Asian patients on the LT waitlist than the current allocation system, original MELD.

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Clinical characteristics and prognosis of Korean patients with hepatocellular carcinoma with respect to etiology

Cited by 10 publications

References 29 publications

The Epidemiology of Hepatitis B Virus Infection in Korea: 15-Year Analysis

The Epidemiology of Hepatitis B Virus Infection in Korea: 15-Year Analysis

The Medical Impact of Emergent Banning of N-nitrosodimethylamine (NDMA)- contaminated Antihypertensive Drug: A nationwide longitudinal cohort study

Validation of MELD 3.0 scoring system in East Asian patients with cirrhosis awaiting liver transplantation

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