To explore the secular trend and impact of treatment modalities for hepatocellular carcinoma (HCC) on survival in Taiwan. Data from 73,817 HCC patients was collected from the Taiwan Cancer Registry between 2011 and 2019. Treatment proportions, secular trend and survival were analyzed based on Barcelona Clinic Liver Cancer (BCLC) staging system. Survival rates differed significantly across BCLC stages, with 5-year survival rates of 70%, 58%, 34%, 11%, and 4% for stages 0, A, B, C, and D, respectively (p < 0.01). Median survival durations were 9.7, 6.3, 2.7, 0.6, and 0.2 years for stages 0 through D. The highest survival was observed in liver transplantation, followed by surgical resection, locoregional therapy, transarterial chemoembolization (TACE), radiotherapy, and targeted therapy. Surgical resection was the most common overall, associated with higher survival in BCLC stages 0-C. In stages 0 and A, locoregional therapy increased from 44.5% to 56.8% and 31.2% to 41.2%, respectively, while TACE declined from 11.6% to 6.3% and 24% to 11.7%. In stage B, resection and locoregional therapy rose from 33.1% to 43.3% and 6.4% to 8.3%, while TACE declined from 49.2% to 43.3%. In stage C, systemic therapy increased from 21% to 37.2% (all p for trend < 0.01). Stage D mainly involved palliative care. The proportion of curative treatments in Taiwan has increased, potentially improving survival outcomes across all BCLC stages.
Kee et al. (Fri,) studied this question.