title: Improved survival trend of patients with hepatocellular carcinoma at an Australian tertiary hospital between 1995-2009.
abstract: OBJECTIVE
  To evaluate trends in survival of patients with hepatocellular carcinoma (HCC) at The Alfred over a 15-year period from 1995-2009
  
  
  METHODS
  A retrospective cohort study of patients with HCC comparing epidemiology, clinical presentation, treatment parameters and overall survival of those diagnosed between 1995-2001 and 2002-2009. Overall survival of patients with primary liver cancer.
  
  
  RESULTS
  The study population consisted of 215 patients; 110 diagnosed between 1995-2001 (Cohort A) and 105 between 2002-2009 (Cohort B). Overall survival increased significantly between 1995-2010 (P = 0.016); median survival was 365 days in Cohort A compared with 665 in Cohort B. The improvement in survival was associated with an increase in the proportion of cases detected at an asymptomatic stage (P = 0.012), a decline in the severity of liver disease at diagnosis (P = 0.002) and increased utilisation of loco-regional therapy (P = 0.001) over the same period. Survival of patients detected through screening was significantly higher than those detected through non-screening methods (1309 vs 233 days, P < 0.001).
  
  
  CONCLUSIONS
  The survival of patients with HCC managed at a tertiary referral centre has improved over the period 1995-2009. This improvement may relate to the increased detection of the disease at an asymptomatic stage (e.g. through screening) as well as increased utilisation of effective loco-regional therapies for HCC.
authors.affiliation: Department of Medical Oncology, The Alfred, Melbourne, Victoria, Australia.
authors.forename: N
authors.initials: N
authors.lastname: Wong
authors.forename: A
authors.initials: A
authors.lastname: Haydon
authors.forename: W
authors.initials: W
authors.lastname: Kemp
authors.forename: P
authors.initials: P
authors.lastname: Wijeratne
authors.forename: S
authors.initials: S
authors.lastname: Roberts
mesh_terms: D000368:Aged; D001315:Australia / Q000453:epidemiology; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D062606:Tertiary Care Centers / Q000639:trends*