HEPATOCELLULAR CARCINOMA IN CENTRAL SLOVAKIA: TERTIARY REFERRAL CENTRE EXPERIENCE WITH 200 PATIENTS

INTRODUCTION  The features of hepatocellular carcinoma (HCC) from various geographical regions differ. Aim: to analyze a cohort from Gr.3 referral centre. METHODOLOGY Retrospective analysis, consecutive outpatients (pts).  Inclusion criterion:  HCC; Exclusion criterion:  insufficient data.  Interval: 2007-2016. RESULTS Cohort=207 pts, 95% with cirrhosis, 76% men. A ge= 62 years.  Etiology  of liver disease: Alcoholic (ALD) = 106 (48%); hepatitis C = 17%; hepatitis B = 13%; non-alcoholic steatohepatitis = 10%; cryptogenic = 7%; non-cirrhotic = 4%; other = 1%.  Dg by  surveillance, = 24%, otherwise = 67%, unknown = 9%. D iameter if Dg by SUR-HCC = 5 cm, otherwise =  8,6 cm ( p=0,001) .  BCLC stages:  A = 30pts (15%); B = 29%; C = 36%; D = 20%;  BCLC according to Dg (SUR-HCC  vs otherwise): A = 15/49 (31%) vs 12/140 (9%); B = 43%  vs  27%; C = 16%  vs  39%; D = 10%  vs  25%.  Treatment:  Surgical resection 17 pts (7%); liver transplantation 14 (6%);  radiofrequency ablation  20 (8%); transarterial chemoembolisation 60 (24%); sorafenib 88 (35%); best of supportive care 46 (19%), 3 pts were awainting LTx.  Mean survival  - 17 months (m) (0,06-112); survival according to BCLC: A = 37 m (2-112); B = 21 (0,6 - 86); C = 14 (0,06-92); D = 3 (0,06-24). CONCLUSION Demographics in our cohort resemble the ones in cohorts from Western Europe and North America. ALD was the most common etiology of underlying liver disease;  95% of pts had cirrhosis. Only 24% of cases were detected via SUR-HCC; therefore, the marked shift to the right in BCLC stage distribution was seen, what resulted in a suboptimal allocation of curative treatments and subsequently to worse survival. The treatment results and the management of HCC in our region is comparable to the standard of health care in West Europe and North America.