Characterization, management, and outcomes of patients with hepatocellular carcinoma in cirrhotic liver treated at a reference center in Cali, Colombia

Abstract

Introduction. Hepatocellular carcinoma (HCC) is one of the most prevalent cancers globally, ranking sixth, and is the third leading cause of cancer mortality. The primary risk factor is liver cirrhosis, with common causes including metabolic dysfunction-associated steatohepatitis (MASH), viral hepatitis, and alcohol consumption. There is a lack of local epidemiological studies characterizing this population in detail. The aim of this study was to describe the demographic, clinical characteristics, and outcomes of adult patients diagnosed with HCC in cirrhotic liver. Methodology. This observational, descriptive, longitudinal study used medical records of patients over 18 years old diagnosed with liver cirrhosis and HCC at Fundación Valle del Lili from January 2014 to December 2019. Detailed descriptions of sociodemographic, clinical, paraclinical variables, and tumor characteristics were recorded. Outcomes included death, liver disease progression, and survival pre- and post-transplant. Results. The study included 212 patients, predominantly men (62%) with a median age of 70 years. The main cause of cirrhosis was MASH (35%), followed by alcohol consumption (17.5%) and hepatitis C (17%). Most patients were classified as Child-Pugh A (57.5%) with a median Model for Endstage Liver Disease (MELD) score of 10. At diagnosis, 45.3% were in the Barcelona classification (BCLC) A, with transarterial chemoembolization (TACE) as the main first-line therapy. The median overall survival was 26 months, with post-transplant survival rates of 88%, 85%, and 79% at 12, 24, and 60 months respectively. Conclusion. The findings align with other Colombian studies, showing high mortality from HCC in cirrhotic patients. This highlights the need for increased awareness and screening for early detection and curative treatment options.