Improved survival trend of patients with hepatocellular carcinoma at an Australian tertiary hospital between 1995-2009

Intern Med J. 2013 Feb;43(2):197-203. doi: 10.1111/j.1445-5994.2012.02755.x.

Abstract

Aim: To evaluate trends in survival of patients with hepatocellular carcinoma (HCC) at The Alfred over a 15-year period from 1995-2009

Methods: A retrospective cohort study of patients with HCC comparing epidemiology, clinical presentation, treatment parameters and overall survival of those diagnosed between 1995-2001 and 2002-2009. Overall survival of patients with primary liver cancer.

Results: The study population consisted of 215 patients; 110 diagnosed between 1995-2001 (Cohort A) and 105 between 2002-2009 (Cohort B). Overall survival increased significantly between 1995-2010 (P = 0.016); median survival was 365 days in Cohort A compared with 665 in Cohort B. The improvement in survival was associated with an increase in the proportion of cases detected at an asymptomatic stage (P = 0.012), a decline in the severity of liver disease at diagnosis (P = 0.002) and increased utilisation of loco-regional therapy (P = 0.001) over the same period. Survival of patients detected through screening was significantly higher than those detected through non-screening methods (1309 vs 233 days, P < 0.001).

Conclusions: The survival of patients with HCC managed at a tertiary referral centre has improved over the period 1995-2009. This improvement may relate to the increased detection of the disease at an asymptomatic stage (e.g. through screening) as well as increased utilisation of effective loco-regional therapies for HCC.

MeSH terms

  • Aged
  • Australia / epidemiology
  • Carcinoma, Hepatocellular / diagnosis
  • Carcinoma, Hepatocellular / mortality*
  • Carcinoma, Hepatocellular / therapy*
  • Cohort Studies
  • Female
  • Humans
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / therapy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Rate / trends
  • Tertiary Care Centers / trends*