Hepatocellular carcinoma (HCC) remains one of the leading causes of cancer-related deaths in the world. Patients with early-stage HCC are treated with liver-directed therapies to bridge or downstage for liver transplantation (LT). In this study, the impact of HCC care delay on HCC progression among early-stage patients was investigated. Early-stage HCC patients undergoing their first cycle of liver-directed therapy (LDT) for bridge/downstaging to LT between 04/2016 and 04/2022 were retrospectively analyzed. Baseline variables were analyzed for risk of disease progression and time to progression (TTP). HCC care delay was determined by the number of rescheduled appointments related to HCC care. The study cohort consisted of 316 patients who received first-cycle LDT. The HCC care no-show rate was associated with TTP (p= 0.004), while the overall no-show rate was not (p= 0.242). The HCC care no-show rate and HCC care delay were further expanded as no-show rates and rescheduled appointments for imaging, laboratory, and office visits, respectively. More than 60% of patients experienced HCC care delay for imaging and laboratory appointments compared to just 8% for office visits. Multivariate analysis revealed that HCC-specific no-show rates and HCC care delay for imaging (p< 0.001) were both independently associated with TTP, highlighting the importance of minimizing delays in early-stage HCC imaging surveillance to reduce disease progression risk.
肝细胞癌（HCC）仍是全球癌症相关死亡的主要原因之一。早期HCC患者通常接受肝脏定向治疗，以作为肝移植的桥接或降期治疗手段。本研究旨在探讨早期HCC患者诊疗延迟对疾病进展的影响。研究回顾性分析了2016年4月至2022年4月期间，为桥接/降期肝移植而接受首轮肝脏定向治疗的早期HCC患者。通过分析基线变量评估疾病进展风险及无进展生存期。HCC诊疗延迟通过HCC相关预约改期次数进行量化。研究队列包含316例接受首轮肝脏定向治疗的患者。HCC诊疗失访率与无进展生存期显著相关（p=0.004），而总体失访率无此关联（p=0.242）。研究进一步将HCC诊疗失访率与延迟细分为影像检查、实验室检测及门诊访视的失访率与改期情况。超过60%的患者在影像和实验室检查中出现诊疗延迟，而门诊延迟仅占8%。多变量分析显示，HCC特异性失访率与影像检查延迟（p<0.001）均独立影响无进展生存期，这凸显了最大限度减少早期HCC影像监测延迟对降低疾病进展风险的重要性。
肿瘤(癌症)患者之家