Survival outcomes of liver cancer patients at a tertiary care cancer center, India: a retrospective cohort study

Background Hepatocellular carcinoma (HCC) has poor survival due to late diagnosis. This study estimated five-year overall survival and factors associated with mortality among HCC patients. Methods This retrospective cohort study included patients with confirmed HCC registered at Tata Memorial Centre during 2018–2019. Clinical variables, including alcohol use, hepatitis status, cirrhosis, biomarkers, and staging by the Barcelona Clinic Liver Cancer (BCLC) system, were extracted from electronic medical records. Overall survival was estimated using the Kaplan–Meier method, and independent determinants using multivariable Cox regression, with hazard ratios re-estimated using inverse probability weighting to account for loss to follow-up. STATA v15.0 was used for statistical analysis. Results Among 1,025 HCC patients (mean age 56.95 ± 12.58 years), 879 (85.76%) were male. Liver cirrhosis was present in 545 (53.17%) patients, hepatitis B infection in 457 (44.59%), and alcohol use in 268 (26.15%). BCLC stage C was seen in 402 (39.22%) patients and stage D in 92 (8.98%), while 815 (79.51%) had moderate impairment. Median overall survival was 10.81 months (1-, 3-, 5-year: 48.17%, 25.72%, 17.75%). Females survived longer than males (17.35 vs. 9.79 months; p=0.03). Survival declined progressively from BCLC stage A to stage D (54.57 to 3.42 months; p<0.001). On weight-adjusted analysis, alcohol use (aHR=1.40), hepatitis B (aHR=1.69), severe impairment (aHR=4.78), and BCLC stage D (aHR=2.88) independently predicted mortality. Combination therapy was associated with improved survival (aHR=0.52) compared with no treatment (aHR=1.44). Conclusion HCC patients in this cohort had poor overall survival, underscoring the need for earlier diagnosis and timely, stage-appropriate treatment to improve outcomes.