Evidence map›Paper›PMID 42330118›Full record

ArticleThe British journal of surgery2026

Global disparities in hepatocellular carcinoma outcomes: a multicentre study.

Sanju Sobnach, Haytham Bayadsi, Urda Kotze, Hanna Nyström, C Wendy Spearman, Mark Sonderup, Inae Kim, Keith Venter, Marc Bernon, Muhammad Emmamally and 3 more

Abstract readMulticenter StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Sanju SobnachDivision of General Surgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Haytham BayadsiDepartment of Diagnostics and Intervention/Surgery, Umeå University, Umeå, Sweden.
Urda KotzeDivision of General Surgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Hanna NyströmDepartment of Diagnostics and Intervention/Surgery, Umeå University, Umeå, Sweden.ORCID 0000-0003-4595-5399
C Wendy SpearmanDivision of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Mark SonderupDivision of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Inae KimDivision of General Surgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Keith VenterDivision of General Surgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.ORCID 0000-0001-6910-1756
Marc BernonDivision of General Surgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Muhammad EmmamallyDivision of General Surgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Luiz F ZerbiniCancer Genomics Group, International Centre for Genetic Engineering and Biotechnology (ICGEB), Cape Town, South Africa.
Oskar HemmingssonDepartment of Diagnostics and Intervention/Surgery, Umeå University, Umeå, Sweden.ORCID 0000-0003-1732-168X
Eduard JonasDivision of General Surgery, Department of Surgery, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.

Funding

Harry Crossley Clinical FellowshipHarry Crossley Foundation at the University of Cape Town
6 · The paper itself

Abstract

backgroundSub-Saharan Africa carries a disproportionate burden of hepatocellular carcinoma (HCC), yet clinical guidelines used on the African subcontinent are extrapolated from high-income countries (HICs). The presentation, treatment, and outcomes of HCC were compared between liver referral centres in South Africa and Sweden to examine the limitations of applying HIC-derived guidelines to sub-Saharan Africa.

methodsThis was a comparative cohort study of adult patients with HCC treated from 2012 to 2023 in a referral centre in South Africa and in a referral centre in Sweden. The main and secondary outcomes were overall survival (OS) and treatment-specific survival respectively.

resultsOf 959 patients included, 455 and 504 were treated in South Africa and Sweden respectively. Patients in South Africa were younger (median 50 versus 71 years, P < 0.001) and predominantly had hepatitis B virus (HBV)-related HCC (60% versus 3.6%, P < 0.001). They presented with more advanced liver dysfunction, more frequent metastases, and more advanced Barcelona Clinic Liver Cancer (BCLC) stage. Curative-intent therapies (ablation, liver resection, or liver transplantation) were offered to 9.2% and 42.5% of patients respectively (P < 0.001). OS rates at 1 year, 3 years, and 5 years were 17.8%, 7.7%, and 5.3% versus 59.3%, 35.3%, and 27.0% respectively (P < 0.001). Survival was consistently lower for the patients in South Africa when comparing treatment-specific cohorts.

conclusionMarked disparities in disease presentation, access to treatment, and survival were observed between regions. Tailored regional guidelines are urgently needed to address these inequities and improve outcomes.

Indexed as

Carcinoma, HepatocellularHealthcare DisparitiesLiver NeoplasmsAdultAgedCohort StudiesFemaleHepatectomyHumansLiver TransplantationMaleMiddle AgedSouth AfricaSwedenTreatment Outcome

Identifiers

PMID42330118
PMCPMC13482978

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.