Improved survival trend of patients with hepatocellular carcinoma at an Australian tertiary hospital between 19952009

Aim To evaluate trends in survival of patients with hepatocellular carcinoma (HCC) at The Alfred over a 15-year period from 19952009 Methods A retrospective cohort study of patients with HCC comparing epidemiology, clinical presentation, treatment parameters and overall survival of those diagnosed between 19952001 and 20022009. Overall survival of patients with primary liver cancer. Results The study population consisted of 215 patients; 110 diagnosed between 19952001 (Cohort A) and 105 between 20022009 (Cohort B). Overall survival increased significantly between 19952010 (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 19952009. 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.