| Objective: This study aims to clarify the current status of surveillance, treatment, and prognosis of initial hepatocellular carcinoma (HCC) cases. Methods: We retrospectively reviewed 1,143 initial HCC cases treated at our department from January 2003 to December 2023, categorized into HBV-related HCC (n=182), HCV-related HCC (n=451), and non-B non-C HCC (NBNC, n=375). NBNC cases included those with steatotic liver diseases (MASH, MetALD, ALD, Cryptogenic) and cryptogenic origins. The study has been approved by the Ethics Committee of K University. Results: 56.6% of the cases underwent surveillance (defined as at least one imaging examination per year). The rate of early-stage diagnosis (BCLC Stage 0/A) and curative treatments were significantly higher in surveilled cases (78.3%/50.6%) compared to non-surveilled cases (36.2%/20.6%), leading to a better prognosis in the former with 1/3/5-year survival rates of 94.7%/84.4%/65.3% versus 74.0%/51.9%/38.0% in the latter (p<0.001). Child-Pugh and ALBI score showed no significant difference between the two groups. Among surveilled cases, 68.5% were managed in liver-disease specialty centers. A cause-specific analysis revealed HCV-related HCC had the highest surveillance rates (74.7%) and best outcomes, while NBNC-related HCC, with the lowest surveillance (37.9%), showed significantly worse prognosis. Discussion: The lack of surveillance was associated with a higher incidence of advanced cases and poorer outcomes, particularly in the NBNC group, indicating the need for targeted surveillance strategies in high-risk populations. |
