CLINICAL AND EPIDEMIOLOGICAL CHARACTERIZATION OF PATIENTS WITH HEPATOCELLULAR CARCINOMA

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Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a leading cause of cancer mortality. In Colombia, approximately 1,300 people die annually from this cause. Main risk factors include cryptogenic cirrhosis, hepatitis C, and nonalcoholic steatohepatitis (NASH), with diagnoses often occurring at advanced stages, limiting curative options. To analyze the clinical, demographic, and therapeutic characteristics associated with clinical outcomes in patients diagnosed with HCC at a high-complexity center in Colombia between 2002 and 2024. A retrospective cohort study with an analytical approach. Medical records of patients aged ≥18 years diagnosed by imaging or histology were reviewed. Sociodemographic variables, comorbidities, lab and imaging findings, tumor staging (BCLC, Child-Pugh, MELD), treatments, and outcomes were collected. Descriptive analyses were performed using R software. A total of 154 patients were included, with a mean age at diagnosis of 64.4 years (95% CI: 63.3–65.4), 65% male. Most common etiologies were cryptogenic cirrhosis (40%), hepatitis C (25%), and NASH (21%). Most patients were Child-Pugh A or B and met transplant criteria (Milan/UCSF). At diagnosis, 63% had a single tumor ≤3 cm, and 40% received locoregional therapy. Histopathology revealed vascular invasion (25%), satellite nodules (20%), and poorly differentiated tumors (30%). Only 1.9% had AFP >1000 ng/mL, with no statistically significant association with vascular invasion. Median NLR was 5.0. Most patients met transplant criteria at diagnosis, although a significant proportion had adverse histological features. There was a trend toward greater vascular invasion in patients with AFP >1000 ng/mL, suggesting the utility of these markers for risk stratification. This study provides key institutional evidence to inform national strategies and develop predictive tools supported by artificial intelligence.

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