Epidemiological characteristics and prognosis of hepatocellular carcinoma: A single-center observational real-world cohort study of 1302 cases

Objective To investigate the epidemiological characteristics and clinical prognosis of hepatocellular carcinoma ( HCC) . Methods 1302 HCC patients who were diagnosed and treated in Hepatology Center, Nanfang Hospital, from January 1, 2011 to October 31, 2017 were enrolled, and their clinical and follow-up data were recorded to analyze epidemiological characteristics, recurrence, and survival. The chi-square test was used for comparison of categorical variables, and the Kaplan-Meier method was used to calculate survival and recurrence rates, log-rank test was used for comparison. Results 1302 patients with a male/female ratio of 8. 50 : 1 and a mean age of52. 46 ± 11. 51 years. Of all 1302 patients, 1163 ( 89. 32%) had HBV infection, with a HBeAg-positive/HBeAg-negative ratio of 1: 3. 05; 32 ( 2. 46%) had HCV infection, and 12 ( 0. 92%) had HBV and HCV infections. Of all patients, 1012 ( 77. 73%) had liver cirrhosis. As for liver function classification, most patients are had Child-Pugh class A-B and albumin-bilirubin grade 1-2 liver disease.As for Barcelona Clinic Liver Cancer ( BCLC) stage, 76 patients ( 5. 84%) had BCLC stage 0, 474 ( 36. 41%) had stage A, 236 ( 18. 13%) had stage B, 504 ( 38. 71%) had stage C, and 12 ( 0. 92%) had stage D HCC. Of all 1302 patients, 261 ( 20. 05%) received radical treatment at baseline, and surgery was the main treatment method; among the remaining 1041 patients ( 79. 95%) , most of them received transarterial chemoembolization. The follow-up time ranged from 0. 27 to 88. 70 months, with a median follow-up time of 13. 33 months.The 5-year median overall survival time of all patients was 21. 53 ± 1. 59 months ( 95% confidence interval [CI]: 18. 411-24. 656) , and there was a significant difference in survival time between the patients with different BCLC stages ( P < 0. 001) . In the patients who received radical treatment, the 5-year median overall survival time was not obtained, and their 5-year median recurrence-free survival time was40. 90 ± 4. 81 months ( 95% CI: 31. 467-50. 333) . Conclusion HCC has the epidemiological characteristics from the aspects of demography, etiology, tumor features, and treatment and prognosis, and there are still problems such as a low rate of identification in the early stage, a low rate of radical treatment, and a short survival time. Strategies for HCC prevention and treatment require further investigation and improvement.