Management of hepatocellular carcinoma: a study on 240 patients in a single referral center

Introduction: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related death globally. Our study aimed to provide an understanding of the risk factors, pattern and management of HCC in a real-life practice. Materials and Methods: Two hundred and forty consecutive patients with HCC were evaluated for an 11-year period (from 2006 to 2016). During the last 5 years the patients were followed up prospectively from the time of the diagnosis to their death. Results: A hundred and seventy-two males and 68 females (mean age 66.4 ± 10.3 and 62.4 ± 9.5 years, respectively) were included in the observation. Hepatitis B virus (HBV) infection accounted for 40.4% and hepatitis C virus (HCV) infection - for 25.8% of the aetiology of liver disease. Cirrhosis is a baseline condition in 82%. HCC was found to be a first complication of liver disease in 2/3 of the studied patients. Using Barcelona Clinic Liver Cancer staging system HCC can be categorised as: stage 0 (n=3); stage A (n=32); stage B (n=52); stage C (n=75) and stage D (n=103). Therefore, the prevalence of very early and early HCC was 13%. Radical therapy (resection or ablation) was recommended in 28% of the patients. Importantly, 18 of 55 (32.7%) patients after surgical resection were followed for more than 3 years without tumour relapse. The median survival, based on the main treatment was: 36 months after surgical resection; 24 months after ablation; 10.5 months for patients on Sorafenib; 9.5 months after TACE and only 3 months for palliative care. Conclusion: Our study confirms the observed trends in underlying diseases, the heterogeneity of survival and underscores the need of early diagnosis of HCC.