P2864 - The Association of Treatment and Tumor Size on Prognosis of Hepatocellular Carcinoma. A Retrospective Analysis of the Surveillance Epidemiology and End Results Database

Samuel Kim, ¹, Raabia Qureshi, ¹, Heer Mehta, ¹, Mahi Gangavarapu, BA¹, Praneet Khanna, BA¹, Bianca Ituarte, BA¹, Tayla Miller, MS¹, Islam Mohamed, MD^2
1University of Missouri - Kansas City School of Medicine, Kansas City, MO; ²University of Missouri, Columbia, MO

Introduction: Hepatocellular carcinoma (HCC) is the most common malignancy of the liver and poses a serious health burden due to its high incidence and mortality. HCC is frequently diagnosed at advanced stages leading to poor prognostic outcomes. Early diagnosis of smaller tumors is key to improving survival rates, as larger tumors correlate with more aggressive disease. This retrospective analysis utilizes the Surveillance Epidemiology and End Results (SEER) database to elucidate the relationship between tumor size, therapeutic modalities, and prognosis of HCC patients to provide insight regarding the effectiveness of surgical interventions, radiation therapy, and systemic chemotherapy.

Methods: Demographic and clinical data of patients with microscopically confirmed HCC were extracted from the Surveillance Epidemiology and End Results (SEER) database. The SEER registries in our study included 17 cancer registries between the years 2000-2020. Cases were identified using the International Classification of Diseases (ICD) for Oncology, Third Revision morphology codes (8170-8175, 8180). Cox proportional hazards model was used to predict risk.

Results: A total of 110, 505 patients were included in this study. Median tumor size was 45 (IQR: 51). Overall, each log millimeter (mm) of tumor size contributed to a 2.4 times increased risk of death (p < 0.001). There is a 1.46 times increase in risk in each log mm when systemic chemotherapy is done after surgery (p < 0.001) and 1.83 times increase in risk each log mm when systemic chemotherapy is done before surgery (p = 0.006). There is a 1.53 times increased risk in each log mm when radiation is used (p < 0.001). There is a 1.81 times (p = 0.014), 1.49 times (p < 0.001), and 1.43 times (p 0.04) increased risk with each log mm when destruction of primary site, excision of primary site, and partial removal of primary site respectively are used. Radical and debulking surgery did not statistically associate with tumor size and prognosis.

Discussion: This study determined that risk changed when various therapies were pursued in HCC patients. Moreover, there was no association between tumor size, prognosis, and radical and debulking surgery and improved survival outcomes. Tumor size is included in many different kinds of staging systems, and this study and others in the literature suggest it as an important diagnostic factor in HCC patients but with variable impact on determining outcomes.


Disclosures:


Samuel Kim, ¹, Raabia Qureshi, ¹, Heer Mehta, ¹, Mahi Gangavarapu, BA¹, Praneet Khanna, BA¹, Bianca Ituarte, BA¹, Tayla Miller, MS¹, Islam Mohamed, MD². P2864 - The Association of Treatment and Tumor Size on Prognosis of Hepatocellular Carcinoma. A Retrospective Analysis of the Surveillance Epidemiology and End Results Database, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.