Observational Study
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 27, 2018; 10(1): 116-123
Published online Jan 27, 2018. doi: 10.4254/wjh.v10.i1.116
High burden of hepatocellular carcinoma and viral hepatitis in Southern and Central Vietnam: Experience of a large tertiary referral center, 2010 to 2016
Song-Huy Nguyen-Dinh, Albert Do, Trang Ngoc Doan Pham, Doan Y Dao, Trinh Nhu Nguy, Moon S Chen Jr
Song-Huy Nguyen-Dinh, Trinh Nhu Nguy, Liver Tumor Department, Cho Ray Hospital, Ho Chi Minh City 700000, Vietnam
Albert Do, Section of Digestive Diseases, Department of Internal Medicine, Yale University, New Haven, CT 06510, United States
Albert Do, Trang Ngoc Doan Pham, Doan Y Dao, Vietnam Viral Hepatitis Alliance, Ho Chi Minh City 7000, Vietnam
Trang Ngoc Doan Pham, School of Public Health, University of Illinois, Chicago, IL 60302, United States
Doan Y Dao, Division of Digestive and Liver Diseases, UT Southwestern Medical Center, Dallas, TX 75390, United States
Moon S Chen Jr, Davis Comprehensive Cancer Center, University of California, Sacramento, CA 95817, United States
Author contributions: Do A, Pham TND and Chen Jr MS contributed to data analysis, interpretation and manuscript preparation; Nguyen-Dinh SH and Nguy TN contributed to data acquisition and analysis; Dao DY contributed to editing and reviewing; all authors contributed to final article approval.
Supported by Cho Ray Hospital (to SH and TN); Vietnam Viral Hepatitis Alliance (to Dao DY and Pham TND); National Institutes of Health T32 training, No. T32 DK 007017-40 (to AD); National Institutes of Health T32 training, No. T32 DK 745-18 (to DD); and National Cancer Institute, No. U54CA153499 (to MC).
Institutional review board statement: Institutional board review of this study was obtained and approved for the methods reported in this study.
Informed consent statement: Informed consent was not obtained owing to de-identified information and risk of personal identification is low.
Conflict-of-interest statement: All authors declare no conflict of interest.
Data sharing statement: Technical appendix and dataset available from corresponding author at mschenjr@ucdavis.edu.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Moon S Chen Jr, PhD, UC, Davis Comprehensive Cancer Center, University of California, 2450 48th Street, Suite 1600, Sacramento, CA 95817, United States. mschenjr@ucdavis.edu
Telephone: +1-916-7341191 Fax: +1-916-7035003
Received: November 6, 2017
Peer-review started: November 7, 2017
First decision: December 4, 2017
Revised: December 15, 2017
Accepted: January 15, 2018
Article in press: January 15, 2018
Published online: January 27, 2018
Research background

Hepatocellular carcinoma (HCC) is currently the world’s second deadliest cancer. HCC is closely linked to viral hepatitis, which in turns has been reported to have high epidemiologic heterogeneity especially in the developing world. There is limited epidemiological data on HCC reported in Vietnam, particularly the southern and central regions.

Research motivation

This study primarily seeks to elucidate the epidemiological characteristics of HCC in southern and central Vietnam. These results have significant policy and research implications in establishing priorities for public health interventions, financial allocations, and driving knowledge acquisition in further large-scale observational studies and potential biomarker testing expansion.

Research objectives

The authors sought to evaluate the burden of HCC and characteristics of patients presenting with HCC, as well as potential disease etiology.

Research methods

The authors conducted an epidemiological observational study from 2000 to 2016, using a large database of patients with liver cancer who receive care at Cho Ray Hospital, the largest tertiary referral center in southern and central Vietnam. Information on patient demographic information, disease staging, and tumor marker results were extracted.

Research results

Analysis was performed on 24091 patients from 2010 to 2016, with increasing disease frequency noted (2793 patients in 2010 to 4069 in 2016). Most patients were male (86.4%), most patients presented with advanced disease (40.8%). Most patients were found to have viral hepatitis (89.6%), with 62.3% with HBV, 26.0% with HCV, and 2.7% with HBV-HCV coinfection. Eight point five percent of patients were younger than 40 years old.

Research conclusions

In the largest epidemiological study conducted for liver cancer in Vietnam to date, we find high and increasing disease burden from 2010 to 2016, which manifests as advanced disease and co-prevalent with viral hepatitis. Demographic patterns suggest higher disease burden on males and disproportionate burden on younger patients.

Research perspectives

These findings emphasize the importance of developing systems and methods to better understand epidemiology of liver cancer, as well as for linkage to care, evaluation, and treatment of both liver cancer and viral hepatitis. Future research should focus on health care services and policy implications for disease screening and treatment outcomes for this population.