CLINICAL OUTCOMES AND LIFE EXPECTANCY OF NON-CURATIVE HEPATOCELLULAR CARCINOMA IN MOROCCO

Background and aim:Hepatocellular carcinoma (HCC) is one of the most common and lethal cancers worldwide, with poor prognosis when diagnosed at intermediate or advanced stages. In Morocco, data on clinical outcomes of non-curative HCC remain scarce. This study aimed to evaluate survival outcomes and prognostic factors in Moroccan patients with intermediate and advanced HCC. Methods:We conducted a retrospective study including 102 patients diagnosed with Barcelona Clinic Liver Cancer (BCLC) stage B or C HCC between January 2015 and August 2023 at Hassan II University Hospital, Fez. Diagnosis was based on EASL imaging criteria or histology when required. Clinical characteristics, liver function (Child-Pugh score), performance status, tumor burden, treatments, and outcomes were analyzed. Survival probabilities were estimated using Kaplan–Meier methods and compared with the log-rank test. Results:The mean age was 66 years, with a male predominance (59%). Cirrhosis was present in 84.8% of cases, mainly related to hepatitis C (44%) and hepatitis B (16%). At diagnosis, 47% were symptomatic, 12% had portal vein thrombosis, and 20% had extrahepatic metastases. Treatments included transarterial chemoembolization (72.5%), sorafenib (8.8%), immunotherapy (1%), or best supportive care (14.7%). Overall survival at 1 and 3 years was 60.5% and 43.8%, respectively, with a median survival of 26 months. Patients treated with TACE achieved a one-year survival of 75% and a median survival of 27 months, significantly better than supportive care alone (4 months, p < 0.001). Conclusion:In this Moroccan cohort, the prognosis of non-curative HCC was strongly influenced by treatment modality, with TACE offering the best survival benefit. These findings highlight the need for early detection, systematic screening in cirrhotic patients, and improved access to systemic therapies, including immunotherapy, to optimize patient outcomes.