Temporal trends and regional variations in hepatocellular carcinoma etiology: a multinational study across Asia.
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Takeuchi Yasuto, Tateishi Ryosuke, Obi Shuntaro, Otsuka Motoyuki, Mochizuki Hitoshi, Jazag Amarsanaa, Yokosuka Osamu, Ogasawara Sadahisa, Kanogawa Naoya, Gonchig Erdenebayar, Matsushita Yuki, Kekilli Murat, Bilican Gulden, Kim Yoon Jun, Hur Moon Haeng, Yu Ming-Lung, Huang Chung-Feng, Morishita Asahiro, Oura Kyoko, Komori Atsumasa, Motoyoshi Yasuhide, Siregar Lianda, Loho Imelda, Yang Ming, Okabe Shuichirou, Ueno Yoshiyuki, Katsumi Tomohiro, Sato Takahisa, Kogure Hirofumi, Masuzaki Ryota, Lesmana Cosmas Rinaldi, Nababan S H H, Nimanong Supot, Huang Yi-Hsiang, Nagamatsu Hiroaki, Yoshida Hideo, Uchino Koji, Hasan Irsan, Kitiyakara Taya, Akamatsu Masatoshi, Okamoto Makoto, Kondo Mayuko, Moriyama Makoto, Sukeepaisarnjareon Wattana, Tangkijvanich Pisit, Thanapirom Kessarin, Yalcin Kendal, Kızıl Hayriye Dilan, Adali Gupse, Akdogan Meral, Gokce Dilara Turan, Balaban Yasemin, Gokcan Hale, Coşar Arif Mansur, Harputluoglu Murat, Bahçecioğlu İbrahim Halil, Atasoy Alp, Kockar Muhammet Cem, Dursun Hakan, Eminler Ahmet Tarik, Sollano Jose, Su Dong Jin, Piratvisuth Teerha, Kao Jia-Horng, Crawford Darrell, Hou Jinlin, Sharma Barjesh Chander, Payawal Diana Alcantara, Gani Rino Alvani, Tanwandee Tawesak, Yang Jin Mo, Lin Han-Chieh, Shiina Shuichiro, Jia Ji-Dong, Lau George, Örmeci Necati, Dokmeci A Kadir, Wei Lai, Sarin Shiv Kumar, Omata Masao
Аннотация
METHODS: This multinational study analyzed 6,261 newly diagnosed HCC patients registered in the APASL Hepatology/Oncology Consortium (A-HOC) from 19 centers across seven Asian countries and regions between 2013 and 2023. Data on demographics, tumor characteristics, etiology, and treatment patterns were collected. Etiologies included hepatitis B virus (HBV), hepatitis C virus (HCV), alcoholic liver disease (ALD), metabolic dysfunction-associated fatty liver disease (MAFLD), MAFLD plus excess alcoholic intake (MAFLD + eAL), autoimmune liver disease, cryptogenic, and others. Temporal trends and regional variations were assessed.
RESULTS: In many countries, HBV remained predominant (43.3%-69.5%) and relatively stable throughout the period, while HCV showed only modest reductions. In Japan, HCV was the leading cause of HCC (33.1%), with a significant decline over time, accompanied by a rise in MAFLD-related HCC. ALD-related HCC increased in South Korea, and MAFLD-related HCC rose in Turkey. Tumor size and stage at diagnosis varied by etiology and region, affecting treatment strategies. Early-stage diagnosis was more frequent in Japan and Taiwan, whereas advanced-stage HCC was common in China and Indonesia.
CONCLUSIONS: Distinct regional patterns and temporal changes in HCC etiology across Asia highlight the need for tailored prevention and surveillance measures. The growing burden of MAFLD-related HCC emphasizes its emerging role in liver cancer development, particularly in regions with declining viral hepatitis.