Overview of the multidisciplinary team activity in patients with hepatocellular carcinoma and their survival outcomes

<h3>Background</h3> Hepatocellular carcinoma (HCC) is the most common primary liver cancer, with increasing incidence, morbidity, and mortality. Although viral aetiologies are declining, metabolic disorders are emerging as the leading cause. Given the growing range of therapeutic options, effective management of HCC requires a multidisciplinary approach. <h3>Patients and methods</h3> This retrospective study analysed patients with HCC who were discussed by a multidisciplinary team (MDT). The study aimed to describe patient characteristics, treatment recommendations, and survival outcomes, including progression-free survival (PFS) and overall survival (OS). <h3>Results</h3> A total of 134 patients were included, with a median age of 68.2 years. Most were male (84.3%) and had an Eastern Cooperative Oncology Group performance status of 1 (67.2%). The majority had early-stage disease (62.7% in Barcelona Clinic Liver Cancer stage 0-A) and multiple comorbidities. We identified that 65 (48.5%) patients were presented in the MDT once, while 69 (51.5%) patients were presented two or more times. The median number of discussions per patient was 2 (range 1-8). Most patients discussed more than once were those diagnosed with early-stage disease at initial presentation. Treatment varied by stage: local ablative therapy was used in 54.8% of early-stage patients, locoregional therapy (LRT) in 37.9% of intermediate stage patients, and systemic therapy in 37.9% of intermediate-stage and 57.1% of advanced-stage patients. The median OS for the full cohort was 20.89 months [95% confidence interval (CI) 16.26-26.78]. Among LRTs, the median PFS was 24.46 months (95% CI 7.93-35.34) for transarterial chemoembolization and 27.77 months (95% CI 4.46-not reached months) for transarterial radioembolization. For systemic therapy, the median PFS was 13.65 months (95% CI 5.36-not reached months) with atezolizumab-bevacizumab and 4.59 months (95% CI 3.01-not reached) with sorafenib. <h3>Conclusion</h3> The study underscores the value of MDT-driven management in HCC, facilitating individualized, stage-specific treatment decisions. Repeated MDT evaluations are crucial for guiding patient care throughout the disease course.