Increasing survival of hepatocellular carcinoma patients in Scotland: a review of national cancer registry data

Objectives This study describes changes in the survival of patients with hepatocellular carcinoma (HCC) registered with the Scottish Cancer Registry between 1985 and 2008. Methods Data on patients diagnosed with HCC were extracted from the Scottish Cancer Registry, along with linked data on treatment and risk factors for liver disease. One-, 3- and 5-year relative survival rates were calculated for each time period and a Cox regression model was used to assess the impact of prior admissions on survival. Results The incidence of HCC increased between 1985 and 2008. The proportion of patients with prior alcohol-related admissions rose over the time period studied from 16.0% to 27.1%. Five-year relative survival increased in women between 19851989 and 20052007 from 0.5% [95% confidence interval (CI) 0.03.7] to 10.6% (95% CI 5.218.1). In men, 5-year relative survival increased from 0.4% (95% CI 0.22.2) to 4.4% (95% CI 1.59.9). Regression analysis showed that older age, history of alcohol-related admissions and deprivation were associated with lower survival, and hospitalization for viral hepatitis was associated with higher survival. Conclusions Against the background of an increasing incidence of HCC in Scotland, survival times have increased substantially.