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• W4386886382 abstract "<h3>Introduction</h3> Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and a major global health concern. Due to its high incidence and mortality, early detection and intervention are crucial for improving patient outcomes and reducing disease burden. Cirrhosis is a significant risk factor for the development of HCC and a correlation between the risk of HCC and the duration and severity of cirrhosis exists. Given this increased risk, patients with cirrhosis require regular surveillance for HCC to facilitate early detection and thus improve outcomes. <h3>Methods</h3> We conducted a case review of all new diagnoses of HCC that were recorded within our hepatobiliary MDTs between February 2018 – November 2022 (57 months). Data was evaluated for demographics, disease status, tumour staging, mode of presentation (surveillance vs non-surveillance), prognosis and treatments offered in cirrhotic patients. <h3>Results</h3> 128 new cases of HCC were identified from our database. 89 (70%) had underlying cirrhosis and are described here. Their median age was 72 and they were predominantly male (72%). NAFLD accounted for most new diagnoses (38%), followed by alcohol (26%), HCV (15%), cryptogenic cirrhosis (9%) and haemochromatosis (6%). Patients were graded according to their Child Pugh (CP) Score: A (42%), B (47%), C (11%). Diagnoses were staged according to the Barcelona Criteria: 0 (1%), A (18%), B (10%), C (27%), D (44%). 56% of HCC diagnoses were in newly presenting index cases of cirrhosis, made outside of the local surveillance programme. These patients were older (median age 74 vs 70) and of more advanced disease staging (CP B/C 74% vs 58% & BCLC C/D 84% vs 54%). As a result, fewer curative treatments were offered outside of the surveillance group (74% vs 41% offered palliative care only) and their prognosis was worse (75 vs 292 days median survival from diagnosis date). <h3>Conclusions</h3> Our data illustrates HCC demographics and staging in a real-world secondary care setting. It highlights the growing tide of older metabolic disease that presents significant challenges when considering treatment options and prognosis given the inherent co-morbid profile of this patient group. It also demonstrates the clear need for more rigorous and structured approaches to cirrhosis detection and HCC surveillance; given that most cirrhotic patients are being diagnosed outside of a surveillance programme, with more advanced disease and thus poorer prognoses. Data from this review supports the ambition of local cancer alliance programmes to invest resources into improving UK HCC surveillance." @default.
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• W4386886382 date "2023-09-01" @default.
• W4386886382 modified "2023-09-27" @default.
• W4386886382 title "P52 Hepatocellular carcinoma surveillance: a comprehensive review" @default.
• W4386886382 doi "https://doi.org/10.1136/gutjnl-2023-basl.68" @default.
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