A nationwide study on hepatocellular carcinoma

Area of Science:

• Hepatology
• Oncology
• Epidemiology

Background:

• Population-based studies on hepatocellular carcinoma (HCC) epidemiology are limited.
• Previous Icelandic studies indicated a low HCC incidence, primarily in non-cirrhotic cases.
• This study aimed to compare cirrhotic HCC (CG) with non-cirrhotic HCC (NCG) in Iceland.

Purpose of the Study:

• To analyze the incidence, etiology, and survival of HCC patients in Iceland.
• To compare characteristics and outcomes between cirrhotic and non-cirrhotic HCC groups.
• To assess trends in HCC diagnosis and their impact on survival.

Main Methods:

• A nationwide, population-based retrospective study of HCC patients diagnosed between 1998 and 2017.
• Analysis of medical records to gather data on patient demographics, etiology, tumor characteristics, treatment, and survival.
• Comparison between cirrhotic HCC (CG) and non-cirrhotic HCC (NCG) groups.

Main Results:

• HCC incidence rose to 1.7/100,000 annually, an 8% increase per year.
• Alcohol and hepatitis C were more common risk factors in CG (13%) than NCG (2%).
• NCG tumors were larger (11 cm vs. 5 cm), with less portal vein thrombosis (11% vs. 30%), and more likely to undergo surgery (44% vs. 23%).
• Surveillance diagnosis increased from 3% (2000-2007) to 19% (2008-2017).
• Median survival for cirrhotic HCC patients diagnosed by surveillance was significantly better (519 days vs. 86 days).

Conclusions:

• Hepatocellular carcinoma incidence has markedly increased in Iceland.
• Non-cirrhotic HCC presents with larger tumors and is more amenable to surgery, but prognosis is not significantly affected.
• Increased surveillance for cirrhotic HCC improves patient survival outcomes.