Survival Outcomes in Hepatocellular Carcinoma: A Decade of Treatment in a Western Tertiary Referral Center.

Background

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Aims

Hepatocellular carcinoma (HCC) remains a challenging malignancy with various available treatments. This retrospective study provides clinical outcomes on staging, treatment, and overall survival (OS) of HCC patients.

Methods

All included patients were diagnosed between 2013 and 2022. OS was assessed using Kaplan-Meier and Cox models, stratified by BCLC stage and diagnosis period.

Results

A total of 1,306 patients were analyzed: 9.1% BCLC-0, 44.3% BCLC-A, 19.1% BCLC-B, 17% BCLC-C, and 10.4% BCLC-D. Median OS (mOS) for the cohort was 19.7 months (95% CI 16.9-23.0), ranging from 86.1 months (95% CI 47.6-not reached) for BCLC-0 to 2.4 months (95% CI 1.7-3.4) for BCLC-D. Poor survival was associated with Child-Pugh (CP) classification (CP-B: HR1.49, 95% CI 1.17-1.89, CP-C: HR2.45, 95% CI 1.57-3.81), and portal vein tumor thrombosis (HR1.75, 95% CI 1.19-2.58). In 2013-2017, 609 patients (46.6%) were diagnosed with mOS of 21.7 months (95% CI 18.4-25.1), while 697 patients (53.4%) in 2018-2022 had mOS of 18.9 months (95% CI 14.8-22.7). Stratified by BCLC stage, mOS in 2013-2017 ranged from 86.1 months (95% CI 41.6-not reached) for BCLC-0 to 2.9 months (95% CI 2.2-5.7) for BCLC-D. In 2018-2022, mOS was 59.8 months (95%CI 44.2-not reached) for BCLC-0, and 1.8 months (95% CI 1.4-3.1) for BCLC-D.

Conclusions

Our clinical data from a consecutive decade-long HCC cohort support the evolution of staging and survival data in HCC management, with CP classification, portal vein tumor thrombosis, and treatment modality as key survival predictors.