Treatment allocation and prognostic biomarkers in hepa-tocellular carcinoma

Hepatocellular carcinoma is one of the leading causes of cancer-related deaths worldwide. The disease frequently returns even after potentially curative treatment, highlighting the need for better methods to select appropriate treatments and predict patient outcomes.

This doctoral thesis investigated treatment decisions and factors associated with survival in patients with hepatocellular carcinoma. The study included patients treated at Oulu University Hospital between 1986 and 2022 and Central Finland Central Hospital between 1997 and 2022. Particular attention was given to microscopic features of liver tumours that can be identified through routine examination of tissue samples.

The results showed that following international treatment recommendations was associated with improved survival among surgically treated patients. Several microscopic tumour features were also associated with patient outcomes. Tumour budding and tumour necrosis were associated with poorer survival. In contrast, clusters of immune cells surrounding the tumour and a desmoplastic growth pattern were associated with better survival.

The findings highlight the importance of careful treatment selection in liver cancer. They also suggest that routinely examined tumour tissue can provide valuable information about patient prognosis. However, further studies involving larger patient groups are needed before these findings can be widely applied in clinical practice.