Hepatocellular carcinoma in Danish patients: a single Copenhagen center experience
Jenna Stefansdottir1, Erik Christensen1, Frank Vinholt Schiødt1
1a Digestive Disease Center K, Section of Medical Gastroenterology , Bispebjerg Hospital, Copenhagen, University of Copenhagen , Copenhagen NV , Denmark.
Insights
Survival for hepatocellular carcinoma (HCC) patients was poor, primarily due to delayed diagnosis. Early detection and increased awareness of HCC and its therapies are crucial for improving outcomes.
Area of Science:
- Hepatology
- Oncology
- Epidemiology
Background:
- Hepatocellular carcinoma (HCC) is a prevalent cancer, often associated with underlying cirrhosis.
- Alcohol-related liver disease and viral hepatitis B or C are primary causes of HCC.
Purpose of the Study:
- To characterize newly diagnosed HCC patients in Denmark.
- To investigate survival rates and identify prognostic factors for HCC patients.
Main Methods:
- Retrospective study of HCC patients diagnosed between 2008 and 2014.
- Kaplan-Meier method for overall survival estimation.
- Multivariate Cox regression analysis to identify survival predictors.
Main Results:
- An incidence rate of 3.55/100,000 people/year was observed.
- Median survival was 81 days, with 1-year survival at 17%.
- Negative prognostic factors included portal vein thrombosis, high Child-Pugh and MELD scores, and high AST levels. Delayed diagnosis was associated with poorer survival.
Conclusions:
- Poor survival in this HCC cohort is largely attributed to diagnostic delays.
- Enhanced public awareness of HCC and available therapies is recommended.
Objective:
Hepatocellular carcinoma (HCC) is a common cause of cancer, and most HCC patients have underlying cirrhosis. Retrospectively, we aimed to characterize patients with newly diagnosed HCC at a Danish hospital and to investigate survival and identify predictive factors for survival.
Methods:
All patients diagnosed with HCC from January 2008 to December 2014 were retrospectively enrolled in this study. Overall survival was estimated by using the Kaplan-Meier method. A multivariate Cox regression analysis was performed to identify predictive factors for survival.
Results:
Sixty-seven patients were diagnosed with HCC (incidence rate 3.55/100,000 people/year). Ninety-three percent had underlying cirrhosis. Alcohol-related liver disease and chronic viral hepatitis B or C were responsible for 55 and 31% of cases, respectively. Median survival was 81 days and 1-month, 3-months and 1-year cumulative survival rates were 74, 40 and 17%, respectively. We identified the presence of portal vein thrombosis, high Child-Pugh score, high MELD score and high AST as independent negative prognostic factors for survival. Survival was poorer in patients seen for the first time when the diagnosis of HCC was made than in patients followed in the outpatient clinic (p = .06) indicating a substantial delay in diagnosis.
Conclusions:
Survival was poor in this cohort of patients, almost exclusively caused by delay in diagnosis and admittance to hospital. An increased general information about HCC and the possibilities of therapy seems warranted.
