Clinical Course and Prognosis of Long‐Term Survivors of Hepatocellular Carcinoma

• Published in: Alimentary pharmacology & therapeutics Vol. 61; no. 8; pp. 1333 - 1342
• Main Authors: Kim, Soon Sun, Lee, Jonghyun, Ahn, Sang Bong, Chon, Young Eun, Yoon, Eileen, Jeong, Soung Won, Jun, Dae Won
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.04.2025
• Subjects: Adult; Aged; Cancer Survivors - statistics & numerical data; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - therapy; Cirrhosis; Diabetes mellitus; Diagnosis; Female; Hepatitis B; Hepatocellular carcinoma; Humans; Liver cancer; Liver Neoplasms - mortality; Liver Neoplasms - therapy; Male; Malignancy; Medical prognosis; Middle Aged; Pancreatic cancer; Patients; Prognosis; Prostate cancer; Republic of Korea - epidemiology; Retrospective Studies; Survival; Survivors; Republic of Korea; prognosis; hepatocellular carcinoma; survival
• ISSN: 0269-2813; 1365-2036; 1365-2036
• DOI: 10.1111/apt.70004

ABSTRACT Background and Aims This study investigated the long‐term prognosis and clinical course of patients who survived for more than 5 years after hepatocellular carcinoma (HCC) diagnosis. Methods This retrospective cohort study used data from the Korean National Health Insurance Service database. A total of 35,348 subjects newly diagnosed with HCC between January 2008 and December 2010 were followed up until December 2018. Results A total of 11,514 (32.6%) survived for 5 years after diagnosis of HCC among 35,348 patients diagnosed with HCC. Long‐term survivors (≥ 5 years) had a higher proportion of females, younger age, more frequent aetiology of hepatitis B virus, less frequent liver cirrhosis, diabetes mellitus and hypertension, and received curative treatment more frequently than nonsurvivors (< 5 years). The additional 1‐, 3‐ and 5‐year cumulative survival probabilities were 90.7%, 77.6% and 68.4% respectively. Patients who underwent curative treatment as the first treatment for HCC showed a higher additional 5‐year cumulative survival probabilities than those treated with noncurative therapy (74.5% vs. 64.2%). Among the long‐term survivors, 44.4% underwent HCC retreatment 5 years after HCC diagnosis. The additional 5‐year cumulative survival probability was 54.9% in the HCC retreatment group. The overall 5‐ and 10‐year cumulative probabilities of second primary malignancies in long‐term survivors were 15.36% and 27.54% respectively. The most frequent second primary malignancy was prostate cancer, followed by colorectal and pancreatic cancers. Conclusion Our study highlights that a significant proportion of patients with HCC achieve long‐term survival beyond 5 years, with favourable outcomes associated with curative treatments. A retrospective cohort study of 35,348 patients with HCC highlights that 32.6% achieved survival beyond 5 years. Curative treatments significantly improved outcomes, while secondary malignancies and retreatments shaped the clinical course of long‐term survivors.