The liver cancer survival rate in the United States
The liver cancer survival rate in the United States varies depending on the stage at which the cancer is diagnosed. According to the American Cancer Society, the 5-year survival rate for people with localized liver cancer (cancer that has not spread to other parts of the body) is about 34%.
If the cancer has spread to surrounding tissues or organs and/or the regional lymph nodes, the 5-year survival rate is about 12%. For liver cancer that has spread to distant parts of the body, the 5-year survival rate is approximately 3%. These statistics can help provide a general understanding of the prognosis for liver cancer, but individual outcomes can vary based on several factors, including the specific characteristics of the cancer and the treatment received.
The liver cancer survival rate in Europe
In Europe, the liver cancer survival rate vary across different countries and are influenced by factors such as healthcare access, early detection, and treatment options. According to data from the European Cancer Information System (ECIS), the 5-year relative liver cancer survival rate in Europe ranges from about 12% to 18% for the period between 2010 and 2014. This rate indicates that, on average, about 12-18 out of 100 people diagnosed with liver cancer are expected to survive for at least 5 years after their diagnosis.
The liver cancer survival rate in China
In China, liver cancer is a significant health concern due to the high prevalence of hepatitis B and C, which are major risk factors for the disease. The liver cancer survival rate in China are generally lower compared to many Western countries, primarily due to late-stage diagnosis and limited access to advanced medical treatments in some regions.
According to the National Cancer Center of China, the 5-year liver cancer survival rate is approximately 12.1% as of 2020. This rate reflects the overall survival for all stages of liver cancer combined. However, survival rates can vary significantly depending on the stage at diagnosis:
- For localized liver cancer, where the tumor is confined to the liver and has not spread to nearby lymph nodes or distant organs, the 5-year survival rate is higher, typically around 30-50%.
- If the cancer has spread to surrounding tissues or regional lymph nodes, the 5-year survival rate drops to about 10-20%.
- For liver cancer that has metastasized to distant organs, the 5-year survival rate is very low, often below 5%.
The liver cancer survival rate in Japan
In Japan, liver cancer is a significant health concern, but the country has made notable strides in early detection and treatment, which has positively impacted survival rates. Japan has a comprehensive surveillance program for individuals at high risk of developing liver cancer, such as those with chronic hepatitis B or C and cirrhosis, which helps in detecting the disease at an earlier stage.
According to the Japanese Society of Hepato-Biliary-Pancreatic Surgery, the 5-year liver cancer survival rate in Japan is approximately 30-50% for patients with early-stage disease. This relatively high survival rate is attributed to the country’s effective screening programs and advancements in surgical techniques and treatments.
According to the data from the “20th Nationwide Follow-up Survey Report on Primary Liver Cancer in Japan” released in 2020, the 5-year survival rate for patients with stage III liver cancer after surgical treatment is 53.1%; for stage IVA, the 5-year survival rate is 32.2%; and for stage IVB, the 5-year survival rate is 25.8%.
Here’s a breakdown of the survival rates based on the stage of liver cancer:
- For localized liver cancer, where the tumor is confined to the liver and has not spread to nearby lymph nodes or distant organs, the 5-year survival rate can be as high as 50-70%.
- If the cancer has spread to surrounding tissues or regional lymph nodes, the 5-year survival rate is lower, typically around 20-30%.
- For liver cancer that has metastasized to distant organs, the 5-year survival rate is significantly lower, often below 10%.
Japan’s approach to liver cancer management, which includes early detection through regular surveillance, minimally invasive surgical techniques, and the use of targeted therapies, has contributed to these favorable survival statistics.
Why does Japan have a higher liver cancer survival rate compared to other countries?
The higher liver cancer survival rate in Japan can be attributed to several factors:
- Early Detection and Surveillance: Japan has a well-established nationwide surveillance program for hepatocellular carcinoma (HCC), which is the most common type of liver cancer. This program has been in place since the 1980s and has contributed to the early detection of liver cancer, particularly in its more treatable stages.
- Advanced Diagnostic and Therapeutic Modalities: Japan has been at the forefront of developing new diagnostic tools and treatment methods for liver cancer, such as computed tomography angiography, anatomical resection, ablation, and transarterial chemoembolization.
- Curative Therapies: A higher percentage of liver cancers detected in Japan are at stages where curative therapies like resection, ablation, or transplantation can be applied. This contributes to better outcomes and higher survival rates.
- Healthcare Infrastructure: The healthcare system in Japan is advanced and widely accessible, ensuring that patients receive timely and appropriate care.
- Cultural and Lifestyle Factors: While not directly related to medical treatment, certain lifestyle and cultural practices in Japan, such as diet and awareness of liver health, may contribute to better management of liver diseases, including liver cancer.
- Demographic Factors: The population of Japan may have different risk factor profiles for liver cancer compared to other countries, which could influence survival rates.
Mid to late-stage liver cancer can also be operated on.
With the continuous development of surgical techniques and the widespread application of perioperative treatment, more and more patients with mid to late-stage liver cancer can also have the opportunity for surgery, extending their survival period.
Conversion therapy
Conversion therapy can improve liver function, reduce tumor volume, cause vascular tumor thrombi to shrink or disappear, and promote compensatory enlargement of the remaining liver volume, creating opportunities for surgical resection or liver transplantation for liver cancer patients, enabling long-term survival for patients with unresectable mid to late-stage liver cancer.
A study published in 2020 using different tyrosine kinase inhibitors (apatinib, lenvatinib) combined with anti-PD-1 antibodies (pembrolizumab, sintilimab, etc.) to treat patients with unresectable hepatocellular carcinoma showed that after targeted combined immunotherapy, 18.3% of patients became eligible for surgical resection.
Neoadjuvant therapy
Neoadjuvant therapy is a treatment that aims to reduce the size of the tumor before surgery, decrease the chance of postoperative recurrence, and extend postoperative survival. For resectable mid to late-stage liver cancer, neoadjuvant therapy can transform liver cancers with poor tumor characteristics into those with better characteristics, thereby reducing the chance of postoperative recurrence and extending survival.
A study published in 2022 from a JAMA journal indicated that Intensity-Modulated Radiation Therapy (IMRT) as neoadjuvant therapy combined with surgery for centrally located hepatocellular carcinoma showed significant effects, with a 5-year overall survival rate much higher than that of patients who only received surgery (69.1% versus 37.2%) .
Another study in 2022 evaluated the efficacy of Opdivo (nivolumab) as monotherapy and in combination with Yervoy (ipilimumab) as perioperative therapy for resectable hepatocellular carcinoma. The results showed that perioperative therapy with Opdivo alone or in combination with Yervoy is safe and feasible for patients with resectable hepatocellular carcinoma, and the dual immunotherapy of Opdivo and Yervoy is more effective, with a progression-free survival of 19.53 months (compared to only 9.4 months with Opdivo monotherapy) .
Proton therapy has shown significant effects on locally advanced liver cancer.
Proton therapy is an emerging form of radiotherapy that, unlike traditional radiotherapy methods, has unique physical properties. It can reduce the dose of radiation to normal lung tissue and other organs around the tumor, concentrating the dose at the site of the lesion. This allows for improved therapeutic effects while reducing side effects caused by radiotherapy.
At present, proton therapy has become an important option for liver cancer radiotherapy, and locally advanced liver cancer that has not metastasized can benefit from it.
A study published in “Clinical Research” in 2019 compared the efficacy of proton therapy with photon therapy (conventional radiotherapy) in treating liver cancer. The study included patients with non-metastatic, unresectable hepatocellular carcinoma diagnosed between 2008 and 2017. The results showed that for liver cancer patients, the median overall survival (31 months vs 14 months) and the 2-year survival rate (59.1% vs 28.6%) for those treated with proton therapy were more than double those of patients treated with photon therapy!
TACE/HAIC has become an option for the treatment of advanced liver cancer.
Transarterial chemoembolization (TACE) and hepatic arterial infusion chemotherapy (HAIC) are one of the effective treatment methods for middle to advanced stage liver cancer.
Transarterial chemoembolization (TACE) is a primary non-surgical treatment for liver cancer. Unlike traditional chemotherapy that affects the whole body, TACE involves injecting a high concentration of chemotherapy drugs directly into the blood vessels supplying the tumor to “kill” cancer cells, thereby controlling the growth and progression of the tumor. This method can improve the efficacy of liver cancer chemotherapy and reduce systemic toxic side effects.
TACE is suitable for the treatment of local liver cancer that has not metastasized or has few metastatic sites.
Hepatic arterial infusion chemotherapy (HAIC) is a regional local chemotherapy that involves continuously infusing chemotherapy drugs into the blood vessels supplying the tumor through a catheter inserted into the femoral artery over an extended period.
Because the liver is a special organ with dual blood supply, the normal liver is mainly supplied by the portal vein, with hepatic arterial blood supply accounting for about 25-30%, while liver cancer tissue is about 90% supplied by the hepatic artery. HAIC can continuously infuse high concentrations of cytotoxic drugs into the tumor through the hepatic artery, exerting a greater killing effect without causing significant adverse effects on normal liver tissue.
Precision drug therapy has become a new hope for the treatment of liver cancer.
Precision drug therapy, including targeted drugs and immunotherapy drugs, has become a new hope for the treatment of middle to advanced stage liver cancer.
Targeted drugs: These include Sorafenib (Nexavar), Lenvatinib (Lenvima), Regorafenib (Stivarga), Cabozantinib (Cabometyx), Bevacizumab (Avastin), Ramucirumab (Cyramza), and others.
Immunotherapy drugs: These include Cabozantinib (Cabometyx), Pembrolizumab (Keytruda), Nivolumab (Opdivo), Ipilimumab (Yervoy), Atezolizumab (Tecentriq), and others.
In recent years, the emergence of combined therapies such as targeted and immunotherapy, and dual immunotherapy has become the main choice for the treatment of advanced liver cancer.
- Avastin (brand name for bevacizumab, a monoclonal antibody known as bevacizumab) combined with the PD-L1 therapy Tecentriq (brand name for atezolizumab, a monoclonal antibody known as atezolizumab) has become the standard first-line treatment for advanced liver cancer.
- The IMBrave150 study results show that the combination therapy of PD-L1 therapy Tecentriq with the targeted drug Avastin (T+A) can significantly improve the prognosis of patients with advanced liver cancer. Compared with the control group, it can reduce the risk of patient death by 42%, increase the one-year survival rate by 12.6%, and extend the disease progression-free survival period by 1.58 times.
- The anti-PD-1 therapy Opdivo (nivolumab) combined with the anti-CTLA-4 therapy Yervoy (ipilimumab) is the first dual immunotherapy to be approved for the patient population with advanced hepatocellular carcinoma.
- The CheckMate-040 clinical trial results show that 33% of patients achieved effective relief, with a duration of relief ranging from 4.6 to more than 30.5 months, 88% of patients had a relief duration of more than 6 months, 56% of patients had a relief duration of more than one year, and 31% of patients had a relief duration of more than two years.
- The anti-CTLA-4 antibody Imjudo (tremelimumab) in combination with the anti-PD-L1 antibody Imfinzi (durvalumab) for the treatment of unresectable hepatocellular carcinoma patients has become an important choice in the field of liver cancer treatment.
- The study results show that compared with the control group, the death risk of hepatocellular carcinoma patients receiving dual immunotherapy was reduced by 22%; the median overall survival was significantly extended (16.4 months vs 13.8 months); the objective response rate increased nearly four times (20.1% vs 5.1%). Moreover, about 31% of hepatocellular carcinoma patients were still alive three years after receiving dual immunotherapy (compared to 20% in the control group) .
