124P - Clinical profile and treatment outcomes of hepatocellular carcinoma from a tertiary care hospital in South India: A retrospective study

Background

The prevalence of hepatocellular carcinoma (HCC) is increasing worldwide. We performed this study to understand the clinical profile and survival outcomes and prognostic factors of HCC patients in India.

Methods

This is a retrospective study, conducted at the Department of Medical Oncology, Madras Medical College, Chennai, India. The records of all patients diagnosed to have HCC as per the EASL criteria, referred to our department between January 2018 and June 2020 were collected. The data were analysed with IBM SPSS Statistics for Windows, Version 23.0.

Results

125 patients with HCC were referred to the Department of Medical Oncology out of which the data of 116 patients were analysed. The mean age at presentation was 58 years. The patients were predominantly males (95% cases). The most common aetiology was alcoholic liver disease (82% cases). None of the patients were diagnosed on routine surveillance. The most common presenting symptoms were loss of weight and loss of appetite (n=102,88%). Majority of the patients belonged to CTP class B(n=54,46.5%). Most of the patients belonged to BCLC stage C(n=60, 51%). Treatment given was as follows: Surgical Resection (n=9, 8%), TACE (n=12,10%), sorafenib (n= 60, 52 %), Best supportive care (n=35, 30%). The median OS was 5.1 months. A significant association was seen between BCLC stage and OS (median OS in stage 0, A, B, C and D being 37, 22, 12, 5.5 and 2 months, respectively, p =<0.0001). The median OS was significantly associated with CTP class (8 months in CTP A, 5.5 months in CTP B and 2.0 months in CTP C,p =0.047).The patients grouped into BCLC C demonstrated a similar overall survival, irrespective of the CTP class (5.5 vs 6 months in CTP A and B respectively, p=0.628).

Conclusions

Alcoholic liver disease was found to be the most common cause of HCC. BCLC stage and CTP were found to be prognostic in terms of OS. As patients belonging to BCLC C had a similar OS irrespective of CTP class, future trials evaluating newer therapies in BCLC C patients may include CTP B patients in good numbers, rather than under-representing them. Most of the patients are detected at a late stage (BCLC C being most common), precluding curative therapies. Improved access to primary health care is the need of the hour.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.