Current status of primary liver cancer and decompensated cirrhosis in Japan: launch of a nationwide registry for advanced liver diseases (REAL)
Current status of primary liver cancer and decompensated cirrhosis in Japan: launch of a nationwide registry for advanced liver diseases (REAL)
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DOI：
10.1007/s00535-022-01893-5
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发表时间：
2022-07-05
影响因子：
6.3
通讯作者：
Koike, Kazuhiko
中科院分区：
文献类型：
--
作者：
Okushin, Kazuya;Tateishi, Ryosuke;Koike, Kazuhiko
我们建立了一个全国性的数据库，存储了原发性肝癌（PLC）和失代偿性肝硬化（DC）患者的入院数据。方法利用日本全国各类疾病登记平台——国家临床数据库建立数据库。与日本肝癌研究小组进行的日本原发性肝癌全国随访调查可以相互交换数据。存储的PLC、DC或两者患者入院时的数据包括治疗细节以及患者特征。结果共分析224家医院21,376例患者入院37,705例（PLC 29,489例，DC 10077例，两者各1862例）。乙型肝炎、丙型肝炎和非病毒性病因的患者比例在PLC中分别为11.9%、36.2%和42.6%，在DC中分别为7.5%、23.8%和55.0%。PLC和DC入院时的平均年龄（±标准差）分别为73±10岁和68±13岁。巴塞罗那临床肝癌（BCLC）分期分别为0、A、B、C、D，分别占22.0%、17.1%、29.6%、15.1%、5.1%。PLC的治疗方式为切除、消融、经动脉化疗栓塞和全身治疗，分别占18.4%、22.8%、33.7%和11.4%。38.2%的DC患者除常规使用利尿剂和醛固酮拮抗剂外，还使用抗利尿激素受体V2拮抗剂。结论PLC入院时治疗方案的分布与初始治疗时不同。新推出的药物广泛用于DC患者。
Background We developed a nationwide database that stores data of patients with primary liver cancer (PLC) and decompensated cirrhosis (DC) on an admission basis. Methods A database was constructed using the National Clinical Database, a nationwide registry platform for various diseases in Japan. Mutual data exchange was possible with the Nationwide Follow-up Survey of Primary Liver Cancer in Japan by the Liver Cancer Study Group of Japan. The stored data on the admission of patients with PLC, DC, or both, included treatment details as well as patient characteristics. Results A total of 37,705 admissions (29,489 PLC, 10,077 DC, and 1862 for both) in 21,376 patients from 224 hospitals were analyzed. The proportions of patients with hepatitis B, hepatitis C, and non-viral etiology were 11.9%, 36.2%, and 42.6%, respectively, in PLC, and 7.5%, 23.8%, and 55.0%, respectively, in DC. The mean ages (+/- standard deviation) on admission with PLC and DC were 73 +/- 10 and 68 +/- 13 years, respectively. The Barcelona Clinic Liver Cancer (BCLC) stage for PLC was 0, A, B, C, and D in 22.0%, 17.1%, 29.6%, 15.1%, and 5.1%, respectively. Treatment modalities for PLC were resection, ablation, transarterial chemoembolization, and systemic therapy in 18.4%, 22.8%, 33.7%, and 11.4%, respectively. A vasopressin receptor V2 antagonist was used in 38.2% in addition to conventionally used loop diuretics and aldosterone antagonists for DC. Conclusions The distribution of treatment options for PLC on admission differed from that of the initial treatment. Newly introduced drugs are widely used in patients with DC.