Evidence map›Paper›PMID 41639358›Full record

ArticleHepatology international2026

Temporal trends and regional variations in hepatocellular carcinoma etiology: a multinational study across Asia.

Yasuto Takeuchi, Ryosuke Tateishi, Shuntaro Obi, Motoyuki Otsuka, Hitoshi Mochizuki, Amarsanaa Jazag, Osamu Yokosuka, Sadahisa Ogasawara, Naoya Kanogawa, Erdenebayar Gonchig and 70 more

Abstract readMulticenter Study
In one paragraph

Article in Hepatology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

80 authors.

Yasuto TakeuchiOkayama University School of Medicine, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan.
Ryosuke TateishiThe University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, Japan. ryotate@g.ecc.u-tokyo.ac.jp.ORCID http://orcid.org/0000-0003-3021-2517
Shuntaro ObiTeikyo University Chiba Medical Center, Ichihara, Japan.
Motoyuki OtsukaOkayama University School of Medicine, 2-5-1 Shikata-Cho, Kita-Ku, Okayama, 700-8558, Japan.
Hitoshi MochizukiYamanashi Central Hospital, kofu, Japan.
Amarsanaa JazagHappy Veritas Hospital, Ulan Bator, Mongolia.
Osamu YokosukaMatsudo City General Hospital, Matsudo, Japan.
Sadahisa OgasawaraChiba University School of Medicine, Chiba, Japan.
Naoya Kanogawa
Erdenebayar GonchigHappy Veritas Hospital, Ulan Bator, Mongolia.
Yuki MatsushitaThe University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, Japan.
Murat KekilliGazi University, Ankara, Türkiye.
Gulden BilicanGazi University, Ankara, Türkiye.
Yoon Jun KimSeoul National University Hospital, Seoul, Republic of Korea.
Moon Haeng HurSeoul National University Hospital, Seoul, Republic of Korea.
Ming-Lung YuKaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Chung-Feng HuangKaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Asahiro MorishitaKagawa University School of Medicine, Kagawa, Japan.
Kyoko OuraKagawa University School of Medicine, Kagawa, Japan.
Atsumasa KomoriNHO Nagasaki Medical Center, Nagasaki, Japan.
Yasuhide MotoyoshiNHO Nagasaki Medical Center, Nagasaki, Japan.
Lianda SiregarDharmais National Cancer Center, Jakarta, Indonesia.
Imelda LohoDharmais National Cancer Center, Jakarta, Indonesia.
Ming YangBeijing Tsinghua Changgung Hospital, Beijing, China.
Shuichirou OkabeMatsudo City General Hospital, Matsudo, Japan.
Yoshiyuki UenoYamagata University School of Medicine, Yamagata, Japan.
Tomohiro KatsumiYamagata University School of Medicine, Yamagata, Japan.
Takahisa SatoTeikyo University Chiba Medical Center, Ichihara, Japan.
Hirofumi KogureNihon University School of Medicine, Tokyo, Japan.
Ryota MasuzakiNihon University School of Medicine, Tokyo, Japan.
Cosmas Rinaldi LesmanaMochtar Riady Comprehensive Cancer Center Siloam Hospitals Semanggi, Jakarta, Indonesia.
S H H NababanMochtar Riady Comprehensive Cancer Center Siloam Hospitals Semanggi, Jakarta, Indonesia.
Supot NimanongFaculty of Medicine Siriraj Hospital, Mahidol University, Nakhon Pathom, Thailand.
Yi-Hsiang HuangTaipei Veterans General Hospital, Taipei, Taiwan.
Hiroaki NagamatsuJuntendo University School of Medicine, Tokyo, Japan.
Hideo YoshidaJapanese Red Cross Medical Center, Tokyo, Japan.
Koji UchinoJapanese Red Cross Medical Center, Tokyo, Japan.
Irsan HasanCipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Taya KitiyakaraFaculty of Medicine Ramathibodi Hospital Mahidol University, Bangkok, Thailand.
Masatoshi AkamatsuJR Tokyo General Hospital, Tokyo, Japan.
Makoto OkamotoJR Tokyo General Hospital, Tokyo, Japan.
Mayuko KondoMitsui Memorial Hospital, Tokyo, Japan.
Makoto MoriyamaMitsui Memorial Hospital, Tokyo, Japan.
Wattana SukeepaisarnjareonKhon Kaen University, Khon Kaen, Thailand.
Pisit TangkijvanichChulalongkorn University, Bangkok, Thailand.
Kessarin ThanapiromKing Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Kendal YalcinDicle University, Diyarbakır, Türkiye.
Hayriye Dilan KızılDicle University, Diyarbakır, Türkiye.
Gupse AdaliUniversity of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Türkiye.
Meral AkdoganAnkara Bilkent City Hospital, Ankara, Türkiye.
Dilara Turan GokceAnkara Bilkent City Hospital, Ankara, Türkiye.
Yasemin BalabanHacettepe University, Ankara, Türkiye.
Hale GokcanAnkara University, Ankara, Türkiye.
Arif Mansur CoşarKaradeniz Technical University, Trabzon, Türkiye.
Murat HarputluogluInonu University, Malatya, Türkiye.
İbrahim Halil BahçecioğluFırat University, Elazığ, Türkiye.
Alp AtasoyBahcesehir University Goztepe Medicalpark Hospital, Istanbul, Türkiye.
Muhammet Cem KockarSuleyman Demirel University, Isparta, Türkiye.
Hakan DursunAtaturk University, Erzurum, Türkiye.
Ahmet Tarik EminlerSakarya University, Adapazarı, Türkiye.
Jose SollanoUniversity of Santo Tomas Hospital, Manila, Philippines.
Dong Jin SuDaehang Hospital, Seoul, Korea.
Teerha PiratvisuthPrince of Songkla University, Hat Yai, Thailand.
Jia-Horng KaoNational Taiwan University Hospital, Taipei, Taiwan.
Darrell CrawfordThe University of Queensland, Brisbane, Australia.
Jinlin HouNanfang Hospital, Southern Medical University, Guangzhou, China.
Barjesh Chander SharmaGovind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
Diana Alcantara PayawalFatima University Medical Center, Valenzuela, Philippines.
Rino Alvani GaniCipto Mangunkusumo General Hospital, Jakarta, Indonesia.
Tawesak TanwandeeFaculty of Medicine Siriraj Hospital, Mahidol University, Nakhon Pathom, Thailand.
Jin Mo YangYonsei University Health System, Seoul, Republic of Korea.
Han-Chieh LinTaipei Veterans General Hospital, Taipei, Taiwan.
Shuichiro ShiinaJuntendo University School of Medicine, Tokyo, Japan.
Ji-Dong JiaBeijing Friendship Hospital, Capital Medical University, Beijing, China.
George LauHumanity & Health Medical Group, Hong Kong, China.
Necati Örmeciİstanbul Health and Technology University, Istanbul, Türkiye.
A Kadir DokmeciAnkara University, Ankara, Türkiye.
Lai WeiBeijing Tsinghua Changgung Hospital, Beijing, China.
Shiv Kumar SarinInstitute of Liver and Biliary Sciences, New Delhi, India.
Masao OmataThe University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, Japan.

Funding

APASL AHOC20230501]
6 · The paper itself

Abstract

backgroundHepatocellular carcinoma (HCC) remains a major health burden in Asia. Advances in antiviral therapies are reshaping the etiological landscape of HCC. This study evaluated temporal shifts in HCC etiology across Asian countries and their clinical implications.

methodsThis 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.

resultsIn 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.

conclusionsDistinct 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.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsAdultAgedAsiaFemaleHepatitis BHepatitis CHumansLiver Diseases, AlcoholicMaleMiddle AgedAsiaEpidemiologyHepatocellular carcinomaTemporal trend

Identifiers

PMID41639358
PMCPMC13121539

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