我们的目的是通过比较全国多中心队列和单中心 HCC 患者不同治疗后的总生存期 (OS)，评估回顾性单中心队列研究对肝细胞癌 (HCC) 预后的普遍性。使用韩国原发性肝癌登记处（多中心队列，n=16,443）和峨山医疗中心 HCC 登记处（单中心队列，n=15,655）的数据对 2008 年 1 月至 2018 年 12 月期间的 HCC 进行分析。主要结局，即初始治疗后的 OS，对整个人群和根据巴塞罗那临床肝脏 (Barcelona-Clinic-Liver) 治疗的 Child-Pugh A 肝功能亚队列（分别为 n=2797 和 n=5151）的两个队列之间进行了比较-癌症 (BCLC) 策略，使用对数秩检验和 Cox 比例风险模型。BCLC 0 期和 A 期患者（59.3% vs 35.2%）以及接受根治性治疗的患者（42.1% vs 32.1%）在单中心队列（Ps<0.001）。多变量分析显示，根据治疗类型，两个队列之间的 OS 存在显着差异：多中心队列与接受治疗的患者的较高死亡风险相关（调整后的风险比 [95% 置信区间]，1.48 [1.39-1.59]）和非治愈性治疗（1.22 [1.17-1.27]），而接受全身治疗（0.83 [0.74-0.92]）和最佳支持治疗（0.85 [0.79-0.91]）的患者风险较低。亚队列分析还表明，两个队列之间的 OS 存在显着差异，接受化疗栓塞 (1.72 [1.48-2.00]) 和消融 (1.44 [1.08-1.92]) 的多中心队列患者的死亡风险较高。 HCC 患者的多中心队列显示，在调整预后变量后，不同治疗方式的 OS 存在显着差异。因此，HCC 治疗的回顾性单中心队列研究的结果可能无法推广到现实世界的实践。© 2024 Kim 等人。

We aimed to evaluate the generalizability of retrospective single-center cohort studies on prognosis of hepatocellular carcinoma (HCC) by comparing overall survival (OS) after various treatments between a nationwide multicenter cohort and a single-center cohort of HCC patients.Patients newly diagnosed with HCC between January 2008 and December 2018 were analyzed using data from the Korean Primary Liver Cancer Registry (multicenter cohort, n=16,443), and the Asan Medical Center HCC registry (single-center cohort, n=15,655). The primary outcome, OS after initial treatment, was compared between the two cohorts for both the entire population and for subcohorts with Child-Pugh A liver function (n=2797 and n=5151, respectively) treated according to the Barcelona-Clinic-Liver-Cancer (BCLC) strategy, using Log rank test and Cox proportional hazard models.Patients of BCLC stages 0 and A (59.3% vs 35.2%) and patients who received curative treatment (42.1% vs 32.1%) were more frequently observed in the single-center cohort (Ps<0.001). Multivariable analysis revealed significant differences between the two cohorts in OS according to type of treatment: the multicenter cohort was associated with higher risk of mortality among patients who received curative (adjusted hazard ratio [95% confidence interval], 1.48 [1.39-1.59]) and non-curative (1.22 [1.17-1.27]) treatments, whereas the risk was lower in patients treated with systemic therapy (0.83 [0.74-0.92]) and best supportive care (0.85 [0.79-0.91]). Subcohort analysis also demonstrated significantly different OS between the two cohorts, with a higher risk of mortality in multicenter cohort patients who received chemoembolization (1.72 [1.48-2.00]) and ablation (1.44 [1.08-1.92]).Comparisons of single-center and multicenter cohorts of HCC patients revealed significant differences in OS according to treatment modality after adjustment for prognostic variables. Therefore, the results of retrospective single-center cohort studies of HCC treatments may not be generalizable to real-world practice.© 2024 Kim et al.