Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Contemporary epidemiology and real-world management of hepatocellular carcinoma (HCC) in Australia: insights from a prospective Australian national clinical quality registry (144796)

Liane Ioannou 1 , Jonathan Abdelmalak 2 , John S Lubel 2 , Simone Strasser 3 , Usha K Khalsa 3 , Georgia Martin 3 , Wendy Swift 3 , Xuan Wu 3 , Katherine Bateman 4 , Andrew Chan 4 , Avik Majumdar 4 , Marie Sinclair 4 , Anouk Dev 5 , Poh W Loh 5 , Steven Bollipo 6 , Merlyn Joseph 6 , Leya Nedumannil 7 , Siddharth Sood 7 , Catherine Yu 7 , Stephen Riordan 8 , Donna Zhuang 8 , Edmund Tse 9 , Marnie Wood 10 , Jactina Holmes 11 , Jessica Howell 11 , Alexander Thompson 11 , Brooke Gaggin 12 , James O'Beirne 12 , William Kemp 2 , Ammar Majeed 2 , Faizah Alam 13 , Myo J Tang 13 , Irene Binu 14 , Namrata Chauhan 14 , Stephanie Elias 14 , Daniel Saitta 14 , Zina Valaydon 14 , Tsz H Yiu 14 , Eileen Lam 1 , John R Zalcberg 1 , Stuart K Roberts 2
  1. Monash University, Melbourne, VIC, Australia
  2. Gastroenterology, Alfred Hospital, Melbourne, VIC, Australia
  3. Gastroenterology, Royal Prince Alfred Hospital, Sydney, NSW, Australia
  4. Gastroenterology and Victorian Liver Transplant Unit, Austin Health, Melbourne, VIC, Australia
  5. Gastroenterology, Monash Health, Melbourne, VIC, Australia
  6. Gastroenterology, John Hunter Hospital, Newcastle, NSW, Australia
  7. Gastroenterology, Northern Health, Melbourne, VIC, Australia
  8. Gastroenterology, Prince of Wales Hospital, Sydney, NSW, Australia
  9. Gastroenterology, Royal Adelaide Hospital, Adelaide, SA, Australia
  10. Gastroenterology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
  11. Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, Australia
  12. Gastroenterology, Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia
  13. Medicine, The Alfred Hospital, Melbourne, VIC, Australia
  14. Gastroenterology, Western Health, Melbourne, VIC, Australia

Background and Aims: Hepatocellular carcinoma (HCC) is a rapidly increasing healthcare burden in Australia. We aimed to evaluate the contemporary epidemiology, clinical characteristics, and real-world patterns of care for HCC in Australia using a prospective national clinical quality registry.

 

Methods: This interim analysis utilised data from the Upper Gastrointestinal Cancer Registry (UGICR) HCC module, a population-based registry involving 17 major centres across all mainland Australian states. Patients with a new diagnosis of HCC from 1 January 2021 were included. Clinical characteristics and initial treatment modalities were compared between liver transplant centres (LTCs) and non-transplant centres (NTCs).

 

Results: A total of 489 patients were analysed (333 LTC, 156 NTC). The cohort was predominantly male (76.7%) with a median age of 67.0 years. Compared to historical data, a marked shift in aetiology was observed, with HCV-related HCC declining to 14.1%, while metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-related disease emerged as leading contributors (18.6% and 21.1% respectively as sole aetiologies). Overall, 56.9% of patients presented with early-stage disease (BCLC 0/A), yet only 42.9% were known to be diagnosed via targeted surveillance. In those with BCLC-A disease, LTCs were more likely to utilise initial TACE (36.0% vs. 16.4%; p=0.021), whereas NTCs favoured upfront ablation. In BCLC-D patients, NTCs relied more heavily on supportive care (66.7% vs. 30.6%; p=0.019) in contrast to LTC patients who were more likely to receive disease modifying treatment.

 

Conclusions: MASLD is emerging as the leading cause of HCC while surveillance uptake remains suboptimal highlighting the importance of both at-risk MASLD case identification and the development of centralised HCC screening for improving the health of Australians. The significant variations in treatment patterns between LTCs and NTCs require further investigation and may provide insights that could lead to targeted quality improvement initiatives.