1000P Trends of characteristics, treatment and prognosis of hepatocellular carcinoma in Japan during the last decade

Abstract

From the 1980s to 2009, prognosis of hepatocellular carcinoma (HCC) in Japan had been improved. Since then, additional treatment modalities have become available. At the same time, we are facing a new problem of rapid increase of non-viral HCC. Here we investigated the trends of clinical characteristics, treatment strategy and prognosis of HCC during the last decade. A total of 1184 patients with newly diagnosed and recurrent HCC treated in Kurashiki Central Hospital between Jan 2009 and Dec 2018 were retrospectively analyzed. The cohort was categorized into four groups according to the treatment period; Jan 2009–Jun 2011 (period 1, N = 487), Jul 2011–Dec 2013 (period 2, N = 468), Jan 2014–Jun 2016 (period 3, N = 382) and Jul 2016–Dec 2018 (period 4, N = 366). Among them, major treatment procedure and use of molecular targeted agents (MTA) were compared by using the Cochran-Amitage test. Evaluated treatment procedures were; surgery, radiofrequency ablation (RFA), stereotactic body radiotherapy (SBRT), transarterial chemoembolization (TACE), and hepatic arterial infusion chemotherapy. We also compared clinical characteristics and survival time between patients with newly diagnosed HCC in period 1(N = 217) and period 4 (N = 173) by using the Fisher’s exact test and the log-rank tests, respectively. As treatment procedure, RFA and TACE significantly decreased, whereas surgery, SBRT, and start of MTA increased during the last decade. In comparison between period 1 and 4, none of age, sex, BCLC stage or Child–Pugh score was significantly different. Regarding the etiology of underlying liver diseases, hepatitis C decreased and non-viral liver diseases increased significantly (p<.001). In the survival time, no significant difference was found (p=.894), even after stratification by their BCLC stage (p=.672) or Child–Pugh class (p=.191). During the last decade, the treatment for HCC has changed significantly, but the prognosis of HCC has not apparently been improved. In addition, the significant shift of causes for HCC to non-viral liver diseases was noted. Taken together, our findings indicate importance of future intervention for prevention and early detection of non-viral liver diseases to overcome HCC.