Dataset Information

Changes in real-life practice for hepatocellular carcinoma patients in the Republic of Korea over a 12-year period: A nationwide random sample study.

ABSTRACT: BACKGROUNDS & AIMS:Comprehensive analyses through nationwide hepatocellular carcinoma (HCC) registries are important to understand health care issues. We assessed changes in real-life practice for HCC over a long time period. METHODS:The Korean Liver Cancer Association and the Korean Central Cancer Registry jointly established the nationwide cohorts of newly diagnosed HCC patients between 2003 and 2005 and between 2008 and 2014. According to sorafenib reimbursement in the Republic of Korea (January 2011), patients were divided into early (E-Cohort: 2003~2010) and late (L-Cohort: 2011~2014) cohorts. RESULTS:L-Cohort (n = 4776) comprised patients with older age (60.8 vs. 58.3 years), higher proportions of patients with well-preserved liver function (75.6% vs. 68.2%) and non-viral etiologies (28.6% vs. 19.4%), and lower proportion of patients with Barcelona Clinic Liver Cancer [BCLC] 0~A stage (46.2% vs. 53.9%) than E-Cohort (n = 8203) (all p<0.05). Proportions of patients undergoing curative treatments were higher in L-Cohort than in E-Cohort (55.0% vs. 35.1%, 23.2 vs. 11.3%, and 17.3% vs. 9.6% in BCLC 0A, B, and C stages, respectively; all p<0.05). Accordingly, compared with that in E-Cohort, overall survival in L-Cohort significantly improved in patients with BCLC 0~A, B, and C stages (all p<0.05). As first-line treatment, 62.4% underwent locoregional treatments (LRTs), whereas only 9.7% received sorafenib, among BCLC stage C patients in L-Cohort. CONCLUSIONS:For the past 12 years, curative treatments became more widely available to BCLC 0~A, B, and C stage patients, generally improving prognosis. Despite sorafenib reimbursement, LRTs remain the mainstay of first-line treatment for BCLC C stage patients.

SUBMITTER: Kim BK

PROVIDER: S-EPMC6797085 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Changes in real-life practice for hepatocellular carcinoma patients in the Republic of Korea over a 12-year period: A nationwide random sample study.

Kim Beom Kyung BK Kim Do Young DY Han Kwang-Hyub KH Seong Jinsil J

PloS one 20191017 10

<h4>Backgrounds & aims</h4>Comprehensive analyses through nationwide hepatocellular carcinoma (HCC) registries are important to understand health care issues. We assessed changes in real-life practice for HCC over a long time period.<h4>Methods</h4>The Korean Liver Cancer Association and the Korean Central Cancer Registry jointly established the nationwide cohorts of newly diagnosed HCC patients between 2003 and 2005 and between 2008 and 2014. According to sorafenib reimbursement in the Republic ...[more]

PMID: 31622424

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Project description:AimTo identify the main trajectories of alcohol misuse among UK military personnel from 12 years after the start of the Iraq war (2003) and the factors associated with each trajectory.DesignLongitudinal cohort study with three phases of data collection (2004-06, 2007-09 and 2014-16).SettingUnited Kingdom.ParticipantsServing and ex-serving personnel of the UK Armed Forces (n = 7111) participating at Phase 1 and at least one follow-up phase of the King's Centre for Military Health Research (KCMHR) cohort study.MeasurementsTrajectories of alcohol misuse were derived from scores using the Alcohol Use Disorders Identification Test (AUDIT-10) over three data collection phases. Demographic and military characteristics were collected and, among the key covariates, post-traumatic stress disorder (PTSD) was measured using the PTSD checklist (PCL-C) and childhood interpersonal stress and violence was measured using items from the Adverse Childhood Experiences questionnaire.FindingsFive trajectories of alcohol misuse were identified, including 'no misuse' (n = 2249, 31.6%) and 'hazardous' (n = 3398, 47.8%), 'harmful' (n = 832, 11.7%), 'severe-to-hazardous' (n = 258, 5.3%) and 'severe' (n = 374, 3.6%) drinking. Substantial changes were evident only among severe drinkers, where more than half reduced over the study period. The factors most strongly associated with belonging to harmful/severe drinking classes were young age, male gender and childhood adversities and antisocial behaviour. Severe drinkers at Phase 1 were more likely to report probable PTSD and shorter military careers and were less likely to serve as Officers. Persistent severe drinkers were less likely to serve in the RAF compared to the Army and were more likely to be reserves. Not misusing alcohol was also associated with reserve status and having left service.ConclusionsIn a cohort of approximately 7000 UK military personnel, trajectories of alcohol misuse appeared stable between 2004 and 2016. More than half of severe drinkers made substantial improvements over the period, but 68% of the cohort continued to drink hazardously or harmfully. Lack of change for the majority of the sample signals the need for strategies to address alcohol misuse and its cultural and psychosocial drivers.

Dataset Information

Changes in real-life practice for hepatocellular carcinoma patients in the Republic of Korea over a 12-year period: A nationwide random sample study.

Publications

Changes in real-life practice for hepatocellular carcinoma patients in the Republic of Korea over a 12-year period: A nationwide random sample study.

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