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