The Prognosis of Liver Cirrhosis in Recent Years in Korea

Abstract

The survival of a recent series of 823 cirrhosis patients who were followed up for a mean of 48 months was analyzed. Cirrhosis was ascribed to alcohol (26%), hepatitis virus B (58%), hepatitis virus C (11%) or both (2%), or was cryptogenic (3%). Features of decompensation were observed in 51% of the patients at entry, and newly developed in 44% of compensated patients within 5 yr. The 5-yr survival after decompensation was 25%. The leading causes of death were liver failure (53%), hepatocellular carcinoma (HCC, 23%), and variceal bleeding (10%). Early detection of HCC significantly improved the survival of cirrhosis patients. Biannual ultrasonography increased the detection rate of small HCC. Mortality of variceal hemorrhage was much lower in patients with Child-Pugh scores from 5 to 8 than in those with scores above 8 (5% vs. 52%). Endoscopic prophylaxis significantly decreased the incidence of first variceal hemorrhage, but the effect was insufficient to improve the rate of survival. Mortality of first spontaneous bacterial peritonitis was 18%. These data suggest that the mortality of major complications of liver cirrhosis has considerably decreased during the last two decades, while there was no remarkable improvement in long-term survival. More efficient management of etiologic factors would be required.

Efficacy and Tolerability of Peginterferon Alpha Plus Ribavirin in the Routine Daily Treatment of Chronic Hepatitis C Patients in Korea: A Multi-Center, Retrospective Observational Study

“…In one study, 11% of 823 cases of liver cirrhosis were ascribed to HCV infection 15. Although HBV infection is still the most common cause of chronic liver disease and HCC, the overall prevalence of HBsAg positivity has decreased as a result of the nationwide vaccination program 16.…”

Current Status of Hepatitis C Virus Infection in Korea

“…The annual incidence of HCC was about 5% among HCV-related cirrhosis, 4% among HBV-related cirrhosis and 1% among non-B, non-C-related cirrhosis [13] . In Korea, approximately 64-70% of HCC were HBV related, 12-17% HCV related, 1.5-8% coinfected with HBV and HCV, and 16-18% were of a non-B, non-C etiology ( fi g. 2 ) [14] .…”

“…This difference may be explained by the time of HBV infection during the perinatal period in the majority of Korean patients, in contrast to the time of HCV infection during adulthood. About one third of HCV-related cirrhotics were heavy alcohol drinkers, and diabetes mellitus was signifi cantly associated with HCVrelated liver cirrhosis [13] .…”

Trace Element Concentration in Primary Liver Cancers—A Systematic Review

“…Nearly 12 to 20% of patients with cirrhosis develop HCC [10][11][12][13][14]. It is not clear whether cirrhosis predisposes to HCC or whether tumor development and fibrogenesis take place concurrently but fibrosis taking a shorter period of time [15].…”