Treatment patterns and survival in patients with hepatocellular carcinoma in the Swedish national registry SweLiv

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M Henriksson1, B Björnsson2, M Sternby Eilard3

  • 1Centre for Medical Technology Assessment, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.

BJS Open
|February 4, 2020
PubMed

Insights

This study analyzed hepatocellular carcinoma (HCC) treatment and survival in Sweden, finding that national guidelines may improve patient outcomes. Liver cancer survival rates varied significantly by treatment type, with transplantation offering the best prognosis.

Area of Science:

  • Hepatobiliary Medicine
  • Oncology
  • Public Health

Background:

  • Nationwide data on clinical features, treatment, and long-term survival for hepatocellular carcinoma (HCC) are limited.
  • This study addresses the need for comprehensive data on HCC patient management and outcomes using a national quality register.

Purpose of the Study:

  • To describe treatment patterns and survival outcomes in patients diagnosed with HCC.
  • To analyze HCC patient data from a national maintained database.

Main Methods:

  • Retrospective review of patients diagnosed with HCC and registered in the Swedish national register of liver and bile duct tumors (SweLiv) from 2009 to 2016.
  • Overall survival (OS) estimation using Kaplan-Meier analysis and log-rank tests to compare subgroups based on clinical features, treatment modalities, and outcomes over time.

Main Results:

  • 3376 HCC patients were registered; 7.3% received transplantation, 14.8% resection, and 11.6% ablation.
  • Palliative treatments included transarterial chemoembolization (TACE) (14.1%) and sorafenib (12.6%), with 39.6% receiving best supportive care (BSC).
  • Five-year survival was ~75% post-transplantation; median OS varied: resection (4.6 years), ablation (3.1 years), TACE (1.4 years), sorafenib (0.5 years), BSC (0.3 years). Median survival for the total cohort increased from 0.9 years (2009-2012) to 1.4 years (2013-2016) post-guideline introduction.

Conclusions:

  • Survival outcomes align with previous smaller cohort studies.
  • The introduction of national guidelines for HCC treatment in Sweden may have contributed to improved patient survival.
Abstract

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