| Title: |
Early-Stage Australian HCC Patients Treated at Tertiary Centres Show Comparable Survival Across Metropolitan and Non-Metropolitan Residency |
| Authors: |
Jonathan Abdelmalak; Simone I. Strasser; Natalie L. Ngu; Claude Dennis; Marie Sinclair; Avik Majumdar; Kate Collins; Katherine Bateman; Anouk Dev; Joshua H. Abasszade; Zina Valaydon; Daniel Saitta; Kathryn Gazelakis; Susan Byers; Jacinta Holmes; Alexander J. Thompson; Jessica Howell; Dhivya Pandiaraja; Steven Bollipo; Suresh Sharma; Merlyn Joseph; Rohit Sawhney; Amanda Nicoll; Nicholas Batt; Myo J. Tang; Stephen Riordan; Nicholas Hannah; James Haridy; Siddharth Sood; Eileen Lam; Elysia Greenhill; Daniel Clayton-Chubb; John Lubel; William Kemp; Ammar Majeed; John Zalcberg; Stuart K. Roberts |
| Source: |
Livers ; Volume 6 ; Issue 1 ; Pages: 2 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2026 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
hepatocellular carcinoma; HCC; metropolitan; rural; regional; remote; non-metropolitan; survival; mortality; outcomes |
| Description: |
Background: Hepatocellular carcinoma (HCC) poses a significant public health challenge in Australia, with poorer survival observed in non-metropolitan populations. This study investigated whether survival disparities persist between non-metropolitan and metropolitan patients if only those with early-stage HCC treated at metropolitan tertiary referral centres are considered. Methods: We performed a retrospective cohort study across ten Australian tertiary centres involving patients with a new diagnosis of Barcelona Clinic Liver Cancer (BCLC) stage 0 or A, recorded from 1 January 2016 to 31 December 2020. Residential postcodes were entered using the Modified Monash (MM) model to define metropolitan versus non-metropolitan residence. The primary endpoint was adjusted for all-cause mortality. Results: Our study included 854 patients (metropolitan n = 612, and non-metropolitan n = 242) with a median follow-up of 42.6 months. We found no significant survival or mortality differences between the two groups with the unadjusted Kaplan–Meier survival analysis (log-rank test p = 0.612) and with the Cox proportional hazards regression analysis (adjusted HR 0.93, 95% CI 0.64–1.34, p = 0.690). As expected, tumour burden, Child–Pugh Score, and Charlson Comorbidity Index (CCI) were significant predictors of mortality. Conclusions: Our findings suggest that previously observed survival disparities may stem from delayed diagnosis and reduced access to tertiary care in non-metropolitan regions and highlight the need for improved HCC surveillance and referral pathways, particularly for rural and Indigenous communities, to mitigate geographic inequities. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://dx.doi.org/10.3390/livers6010002 |
| DOI: |
10.3390/livers6010002 |
| Availability: |
https://doi.org/10.3390/livers6010002 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.C01CF01A |
| Database: |
BASE |