TBA (16S156)

Hepatocellular Carcinoma in Ireland: An Analysis of National Cancer Registry Data from 1994-2008

Author(s)

Caroline Gaynor1, Masood Iqbal 2 , Harry Comber3 , Sandra Deady3, Mary Teeling1, Aiden McCormick2

Department(s)/Institutions

1School of Medicine, Trinity College Dublin 2Liver Unit, St Vincent’s University Hospital,Dublin 3National Cancer Registry Ireland

Introduction

Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of liver and the third leading cause of cancer mortality worldwide.The incidence of hepatocellular carcinoma is increasing in low prevalence countries such as the US, UK and Ireland. Over the past 2 decades diagnostic techniques have improved and new treatments have been introduced.This analysis reports on whether increasing use of surgical intervention over time has improved prognosis for liver cancer patients in Ireland over the period 1994 – 2008.

Aims/Background

The aim of this study was to determine whether there has been an impact on hepatoma mortality in Ireland.

Method

Anonymised cancer registration data from the National Cancer Registry of Ireland was used to investigate patient characteristics and trends in treatment and survival for Irish patients diagnosed with histologically confirmed HCC between 1994 and 2008. Analyses were conducted according to gender, age, stage of disease treatment received and period of incidence.

Results

The dataset consisted of anonymised case reports of primary liver cancer cases (n=1,609) diagnosed and notified to the NCRI between 1994 and 2008. Only patients with histologically confirmed HCC were included in the analysis. Four hundred and seventy six applicable cases notified to the registry from 1994 through to 2008 were eligible for descriptive analysis. Males accounted for 77% of cases.62% of the 476 patients were aged 60-79 years.Incidence of HCC in Ireland steadily increased from 1994-2008. Median overall survival was 580 days for the entire cohort with 1, 2, 3, and 5-year survivals of 56%, 46%, 39% and 36% respectively. One-year cause specific survival improved from 38% during 1994-1998, to 51% during 1999-2002 to 66% during 2003-2007. Five-year cause-specific survival also improved over time from 19% to 34% to 38% respectively. Surgery was associated with 1, 2, 3 and 5-year survivals of 92%, 82%, 78% and 78% respectively.

Conclusions

Prognosis improved over time in this biopsy proven cohort of patients with hepatocellular carcinoma. This improvement in survival seemed to be largely due to the effect of surgical interventions.