Oidov Baatarkhuu1,2,3,4, Do Young Kim1,4, Pagbajabyn Nymadawa5, Seung Up Kim1,4, Kwang-Hyub Han1,5,4,6, Jazag Amarsanaa3, Dagvasumberel Gonchigsuren7, Ravjir Sanduijav8, Zundui Lkhagvasuren9, Naran Khorolsuren2, Ravjir Oyungerel2, Sang Hoon Ahn10,11,12. 1. Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, South Korea. 2. Department of Infectious Diseases, Health Sciences University, Ulaanbaatar, Mongolia. 3. Mongolian Association for the Study of Liver Diseases, Ulaanbaatar, Mongolia. 4. Liver Cirrhosis Clinical Research Center, Seoul, South Korea. 5. Mongolian Academy of Medical Science, Ulaanbaatar, Mongolia. 6. Brain Korea 21 Project for Medical Sciences, Seoul, South Korea. 7. Department of Radiology, Health Sciences University, Ulaanbaatar, Mongolia. 8. Department of Surgery, National Cancer Center, Ulaanbaatar, Mongolia. 9. Department of Radiology, General Hospital #3, Ulaanbaatar, Mongolia. 10. Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, Seodaemun-gu, 120-752, Seoul, South Korea. ahnsh@yuhs.ac. 11. Liver Cirrhosis Clinical Research Center, Seoul, South Korea. ahnsh@yuhs.ac. 12. Brain Korea 21 Project for Medical Sciences, Seoul, South Korea. ahnsh@yuhs.ac.
Abstract
PURPOSE: Hepatocellular carcinoma (HCC) is the most common cancer in Mongolia. We aimed to investigate the clinical features, therapeutic modalities, overall survival and prognostic factors for Mongolian patients with HCC. METHOD: One hundred ninety-five patients with HCC were consecutively enroled in our study. RESULTS: The mean age was 61.7 years. The most common etiology for HCC was HCV infection (n = 89, 45.6%), followed by HBV infection (n = 67, 34.4%). The mean tumor diameter was 6.0 ± 2.6 cm. Only 29 (14.9%) patients had a single lesion, while 39 (20.2%) had >3 lesions. Extrahepatic metastasis to lung (n = 23), bone (n = 10) and lymph node (n = 3) were detected in 36 (18.5%) patients. Most patients had advanced HCC-88 (45.1%) in stage III and 57 (29.2%) in stage IV. Surgical resection was performed in 27 (13.8%) patients, RFA in 23 (11.8%) and TACE in 107 (54.9%). When all the patients were categorized as 'treated' (n = 156) and 'not treated' (n = 39), the 3-year survival was significantly lower in the 'not treated' group than in the 'treated' group (11 vs. 0%, P < 0.001). Tumor diameter (<3 cm vs. ≥3 cm), extrahepatic metastasis, TNM stage (I/II vs. III/IV) and treatment (or supportive care) were selected as independent predictors for survival. CONCLUSIONS: High proportion of patients with HCC in Mongolia is diagnosed at an advanced stage and survival of these patients is lower compared to other countries. A surveillance system and referral policy for high-risk groups should be urgently established and implemented in Mongolia.
PURPOSE:Hepatocellular carcinoma (HCC) is the most common cancer in Mongolia. We aimed to investigate the clinical features, therapeutic modalities, overall survival and prognostic factors for Mongolian patients with HCC. METHOD: One hundred ninety-five patients with HCC were consecutively enroled in our study. RESULTS: The mean age was 61.7 years. The most common etiology for HCC was HCV infection (n = 89, 45.6%), followed by HBV infection (n = 67, 34.4%). The mean tumor diameter was 6.0 ± 2.6 cm. Only 29 (14.9%) patients had a single lesion, while 39 (20.2%) had >3 lesions. Extrahepatic metastasis to lung (n = 23), bone (n = 10) and lymph node (n = 3) were detected in 36 (18.5%) patients. Most patients had advanced HCC-88 (45.1%) in stage III and 57 (29.2%) in stage IV. Surgical resection was performed in 27 (13.8%) patients, RFA in 23 (11.8%) and TACE in 107 (54.9%). When all the patients were categorized as 'treated' (n = 156) and 'not treated' (n = 39), the 3-year survival was significantly lower in the 'not treated' group than in the 'treated' group (11 vs. 0%, P < 0.001). Tumor diameter (<3 cm vs. ≥3 cm), extrahepatic metastasis, TNM stage (I/II vs. III/IV) and treatment (or supportive care) were selected as independent predictors for survival. CONCLUSIONS: High proportion of patients with HCC in Mongolia is diagnosed at an advanced stage and survival of these patients is lower compared to other countries. A surveillance system and referral policy for high-risk groups should be urgently established and implemented in Mongolia.
Authors: Y Kondo; M Mizokami; T Nakano; T Kato; R Ueda; M Mukaide; K Hikiji; T Ishida; D Dorjsuren; B Dashnyam; T Oyunsuren Journal: J Med Virol Date: 1997-06 Impact factor: 2.327
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