Background: Hepatocellular carcinoma (HCC) continues to pose a significant global health burden, especially when diagnosed at a symptomatic or advanced stage. In such cases, prompt and well-coordinated treatment plays a key role in improving patient outcomes. This study explores the effect of introducing the Order–Map–Treat (OMT) protocol, designed to streamline clinical decision-making and minimize treatment delays, on the survival of HCC patients undergoing transarterial radioembolization (TARE).Methods: This retrospective cohort included 185 HCC patients (69.2% males), of which 88 (47.6%) underwent TARE before the implementation of the OMT system in 2021 (Group 1) and 97 (52.4%) afterwards (Group 2). The mean age of the entire cohort was 71 ± 12 years. A significantly larger number of patients treated before 2021 had an ECOG score of 0 (p< 0.001). Group 1 had significantly more multifocal disease, while group 2 had more unilobar involvement. More patients with PVTT3 and PVTT4 were treated after the implementation of the OMT protocol (p= 0.009).Results: The OMT protocol significantly reduced the median decision to treatment period (p-value ≤ 0.001) from 37 days to 15 days and mapping to the TARE period from 21 days to 1 day, shortening the total days needed for treatment by 32 days approximately. The median survival from TARE was 1.4 years (95% CI: 1.1 to 1.6) for the entire cohort. When stratified by treatment period, patients treated before OMT had a median survival of 1.5 years (95% CI: 1.2 to 1.9), while those treated after OMT implementation had a median survival of 1.2 years (95% CI: 0.9 to 1.6). The difference was not statistically significant (p= 0.415).Conclusions: While there were no significant survival benefits, the OMT protocol offers more efficient HCC management by minimizing delays in treatment, potentially improving patient experience and cost effectiveness.
背景：肝细胞癌（HCC）在全球范围内持续构成重大健康负担，尤其是在出现症状或进展期确诊时。在此类情况下，及时且协调良好的治疗对改善患者预后至关重要。本研究探讨了引入旨在优化临床决策并减少治疗延误的"医嘱-影像规划-治疗"（OMT）流程对接受经动脉放射栓塞术（TARE）的HCC患者生存期的影响。 方法：本回顾性队列研究纳入185例HCC患者（男性占69.2%），其中88例（47.6%）在2021年OMT系统实施前接受TARE治疗（第1组），97例（52.4%）在实施后接受治疗（第2组）。全队列平均年龄为71±12岁。2021年前治疗的患者中ECOG评分为0者显著更多（p<0.001）。第1组多灶性病变显著更多，而第2组单叶受累更多。OMT流程实施后治疗了更多PVTT3和PVTT4患者（p=0.009）。 结果：OMT流程使中位决策至治疗时间从37天显著缩短至15天（p≤0.001），影像规划至TARE时间从21天缩短至1天，总治疗所需时间减少约32天。全队列TARE术后中位生存期为1.4年（95% CI：1.1-1.6）。按治疗时期分层分析显示，OMT实施前治疗患者中位生存期为1.5年（95% CI：1.2-1.9），实施后治疗患者为1.2年（95% CI：0.9-1.6），差异无统计学意义（p=0.415）。 结论：尽管未观察到显著的生存获益，但OMT流程通过最大限度减少治疗延误实现了更高效的HCC管理，可能改善患者就医体验并提高成本效益。
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