Survival following treatment for hepatocellular carcinoma is significantly better in Southeast Asian (SEA) patients compared to non-sea patients.

A recent study highlighted that race influences survival in patients with hepatocellular carcinoma (HCC) with Asian patients having the best survival (Cancer 2010). Aim to determine if a difference exists between Southeast Asian (SEA) and non-SE Asians presenting with HCC at our centre. Method A prospective HCC database was used to identify all patients diagnosed with HCC between Jan 2000 and Dec 2009. Demographics, tumour characteristics, treatment and survival were compared in patients originating from SEA and non-SEA countries. Result(s): Over the 10-year study period 176 patients were diagnosed with HCC, of these 61 (35%) were from SE Asia; the remainder were from Australia, Europe, North Asia and South America. In the SEA and non-SEA groups, the majority of patients were male (77% and 79%); the mean age was similar (61 and 63 years). The main risk factor for HCC in SE Asians was viral hepatitis in 96% (Hepatitis B [HBV] 51%, Hepatitis C [HCV] 45%). In the non-SEA group, the commonest risk factor was alcohol excess (41%) followed by HCV (27%) and HBV (15%). Cirrhosis was present in 92% of SEA and 98% of non-SEA patients (p = ns). The majority of SEA patients had compensated cirrhosis (Childs Pugh Turcotte [CPT] A 82%, B 12%, C 6%); more non-SEA patients presented with decompensated disease (CPT A 50%, B 33%, C 27%). There was no difference in afetoprotein values (normal in 33% SEA and 47% of non-SEA) or in tumour size between SEA and non-SEA groups (<5 cm: 63% vs. 57%, 5-10 cm: 20% vs. 27%, <10 cm: 17% vs. 16%). SEA patients were less likely to present with multifocal disease than non-SE Asians (25% vs. 45%, p = 0.02). SEA patients underwent significantly more potentially curative treatments (liver transplantation or resection, radiofrequency ablation) than non-SE Asians (28% vs. 10%, p = 0.008). There was no difference in the number of patients offered TACE (41% vs 39%). Overall survival was superior in SEA compared to non-SEA patients (median 39 months vs. 16