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Fig 1.

Flow chart of the patients enrolled.

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Table 1.

Baseline characteristics of the HCC population, according to the modified BCLC stage.

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Table 2.

Distribution of patients and treatment options.

(N = 1801).

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Fig 2.

Overall survival curves according to modified BCLC staging system.

BCLC 0 vs. A, p = 0.001; 0 vs. B, p < 0.001; 0 vs. C, p < 0.001; 0 vs. D, p < 0.001; A vs. B, p < 0.001; A vs. C, p < 0.001; A vs. D, p < 0.001; B vs. C, p < 0.001; B vs. D, p < 0.001; C vs. D, p = 0.015.

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Fig 3.

A. Overall survival curves in BCLC 0 patients, according to received treatment. Solid line = Treatment according to BCLC recommendation, median survival 81.1 months (95% CI = 63.9- not available). Dotted line = Downward treatment stage migration. median survival 73.0 months (95%- CI = 55.1-not available). B. Overall survival curves in modified BCLC A patients, according to received treatment. Solid line = Treatment according to BCLC recommendation, median survival 73.0 months (95% CI = 67.8–74.9). Dotted line = Downward treatment stage migration. median survival 45.8 months (95% C I = 36.0–57.1). C. Overall survival curves in modified BCLC B patients, according to received treatment. Dashed line = upward treatment stage migration, median survival 81.1 months (95% CI = 44.8- not available). Solid line = Treatment according to BCLC recommendation, median survival 28.2 months (95% CI = 23.0–36.0). Dotted line = downward treatment stage migration, median survival 15.9 months (95% CI = 1.0–25.0). Upward treatment vs. recommended, p = 0.001; Upward treatment vs. downward, p < 0.001; recommended treatment vs. downward, p = 0.001. D. Overall survival curves in modified BCLC C patients, according to received treatment. Dashed line = upward treatment stage migration, median survival 24.0 months (95% CI = 19.1–30.1). Solid line = Treatment according to BCLC recommendation, median survival 6.1 months (95% CI = 4.9–8.1). Dotted line = downward treatment stage migration, median survival 4.2 months (95% CI = 3.2–5.9). Upward treatment vs. recommended, p < 0.001; Upward treatment vs. downward, p < 0.001; recommended treatment vs. downward, p = 0.812. E. Overall survival curves in modified BCLC D patients, according to received treatment. Dashed line = upward treatment stage migration, median survival not reached (95% CI = 40.9-not available). Solid line = Treatment according to BCLC recommendation, median survival 2.9 months (95% CI = 2.0–3.2).

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Table 3.

Characteristics of patients with adherence and non-adherence to BCLC guidelines recommendation in BCLC stage 0.

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Table 4.

Characteristics of patients with adherence and non-adherence to BCLC guidelines recommendation in BCLC stage A.

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Table 5.

Characteristics of patients with adherence and non-adherence to BCLC guidelines recommendation in BCLC stage B.

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Table 6.

Characteristics of patients with adherence and non-adherence to BCLC guidelines recommendation in BCLC stage C.

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Table 7.

Characteristics of patients with adherence and non-adherence to BCLC guidelines recommendation in BCLC stage D.

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Table 8.

Univariate and multivariate analysis of overall survival in BCLC stage 0.

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Table 9.

Univariate and multivariate analysis of overall survival in BCLC stage A.

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Table 10.

Univariate and multivariate analysis of overall survival in BCLC stage B.

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Table 11.

Univariate and multivariate analysis of overall survival in BCLC stage C.

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Table 12.

Univariate and multivariate analysis of overall survival in BCLC stage D.

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