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| Changed clinical aspects of primary liver cancer in China during the past 30 years |
| Bing-Hui Yang, Jing-Lin Xia, Li-Wen Huang, Zhao-You Tang, Ming-Shan Chen, Jin-Qing Li, An-Min Liang, Qin-Guo Mo,Hui-Shan Lu, Chao-Liu Dai, Lu-Nan Yan, Zhi-Jian Yu, Rong-Sheng Rao, Le-Qun Li, Zhi-Xiong Su, Zhuang-Wei Fang |
Shanghai, China
Author Affiliations: Liver Cancer Institute & Zhongshan Hospital, Fudan University, Shanghai 200032, China (Yang BH, Xia JL, Huang LW and Tang ZY); Tumor Hospital, Zhongshan University, Guangzhou 510000, China (Chen MS and Li JQ); Tumor Hospital, Guangxi Medical University, Nanning 530000, China (Liang AM and Mo QG); Xiehe Hospital, Fujian Medical University, Fuzhou 350000, China (Lu HS); Second Hospital, Chinese Medical University, Shenyang 110000, China (Dai CL); Huaxi Hospital, Sichuan University, Chengdu 610041, China (Yan LN); Hospital Affiliated to Nantong Medical University, Nantong 226000, China (Yu ZJ); Second Hospital, Jiangxi Medical University, Nanchang 330000, China (Rao RS); First Hospital Affiliated to Guangxi Medical University, Nanning 530000, China (Li LQ and Su ZX); People’s Hospital of Hainan Province, Haikou 570000, China (Fang ZW)
Corresponding Author: Bing-Hui Yang, MD, Liver Cancer Institute & Zhongshan Hospital, Fudan University, Shanghai 200032, China (Tel: 86-21-64037250; Fax: 86-21-64037250; Email: bhyang@zshospital. net) |
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Abstract BACKGROUND: Primary liver cancer (PLC) is one of the most frequently seen tumors in China. Thirty years ago, patients with PLC were often detected at relatively late stage, with a palpable mass or marked clinical symptoms and poor prognosis. In the past 30 years, the diagnosis and treatment of PLC have been greatly improved with better prognosis.
METHODS: In order to study the changes of PLC during the 30 years, the clinical data of 3250 patients with PLC from 10 medical institutions of China were collected, analyzed, and compared with those of 3254 PLC patients before the 30 years.
RESULTS: In the 3250 patients aged 1-80 years, with an average age of 49.1 years, the male to female ratio (2.3∶1) was lower than that before the 30 years. 73.5% of the 3250 patients sought medical advice within 3 months after the onset of the disease in contrast to 63.8% before the 30 years. Compared with those patients before the 30 years the symptoms and signs were alleviated generally. The HBsAg positive rate was 81.0%, but the HCV-Ab positive rate was 13.2%. The AFP level in 75% of patients was elevated, but in the remaining 25% was normal. 1912 patients (58.8%) were confirmed pathologically. Among them 1755 patients (91.8%) had hepatocellular carcinoma. The overall resection rate was 46.3%. Those who had early, middle, late stage carcinoma accounted for 29.9%, 51.5%, and 18.6% respectively in contrast to 0.4%, 47.0%, and 52.6% reported before the 30 years. The 1-, 3-, 5-year survival rates of the patients were 66.1%, 39.7%, and 32.5% respectively, whereas 93.5%, 70.1%, and 59.1% for the early stage patients, and 65.3%, 30.5%, and 23.5% for the middle stage patients. The half and 1-year survival rates of the late stage patients were 52.5%, and 14.7%, respectively.
CONCLUSION: Comparison with the clinical data before and after the 30 years show that PLC can be diagnosed early. More PLC patients tend to undergo resection while receiving a better conservative treatment, which ensures a prognosis.
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2004, Vol. 3 
