The Influence of Sex and Age on Survival in Patients with Hepatocellular Carcinoma.

Age and biological sex are risk factors for hepatocellular carcinoma (HCC) occurrence, but their impact on overall survival (OS) is a matter of debate. This study aims to investigate how sex and age at diagnosis, along with other associated factors (i.e., comorbidities, etiologies, therapy) impact OS in the HCC population. Data from two HCC cohorts-a prospective registry from the University Hospital of Bern, Switzerland, and a retrospective registry from General Hospital Vienna, Austria-were combined and analyzed. Clinical and laboratory data were reviewed, and OS was compared using Kaplan-Meier curves and the log-rank test. Cox regression models with penalized splines were applied to examine how age at diagnosis influenced OS. Of 1547 HCC patients, 1284 (84.1%) were male. Females were older (67 vs. 63 years, < 0.001) and had lower rates of liver cirrhosis ( < 0.001), cardiac comorbidities ( < 0.001), and diabetes ( < 0.001). No significant difference in median OS between men and women was observed (18 months vs. 16 months, = 0.304). Mortality risk increased with age, particularly between 60 and 70 years. However, after adjusting for treatment, the age effect became non-significant ( = 0.171). After controlling the model for therapy, neither age nor sex independently influenced OS in HCC patients, underscoring the impact of therapy on survival.