Interventional Radiology Leads Multidisciplinary Care in Liver Cancer Treatment
Interventional radiology dominates hepatocellular carcinoma (HCC) care across treatment lines, highlighting its central role in multidisciplinary management while underscoring opportunities to better coordinate care across specialties, according to study results published in the Journal of Hepatocellular Carcinoma.
HCC, the most common primary liver cancer and the third leading cause of cancer death worldwide, is complex to manage due to underlying liver disease and multidisciplinary care needs. Nearly 41 000 US cases were expected in 2024. Although treatment is guided by the Barcelona Clinic Liver Cancer (BCLC) staging system, real-world care often varies based on patient factors and institutional expertise.
“The present study aimed to map real-world specialty utilization and treatment sequencing in HCC care across three Mayo Clinic liver transplantation sites by identifying which specialties initiate and continue care across treatment lines and BCLC stages,” explained Fatima Islam, Department of Interventional Radiology, Mayo Clinic Florida, Jacksonville, FL, and coauthors.
Researchers reviewed data from 4799 patients with complete records between May 2020 and May 2025, of whom 3079 received at least 1 treatment. Most patients (87%) had a hepatology consultation. Across all treatment lines, interventional radiology was the most frequently involved specialty, delivering 37% of first-line treatments, 41% of second-line treatments, and 46% of third-line or later treatments. Medical oncology accounted for 27%, 28%, and 29% of treatments across these lines, respectively, while transplant surgery, radiation oncology, and hepatopancreatobiliary surgery contributed smaller proportions.
Treatment patterns revealed that interventional radiology not only initiated care for many patients but also remained central throughout disease progression. Among patients receiving interventional radiology as first-line therapy, 36% required no additional treatment, while 35% underwent repeat interventional radiology procedures. Others transitioned to transplant (16%), systemic therapy (8%), or radiation (4%). In contrast, most transplant procedures (69%) occurred after prior treatment from another specialty, emphasizing its role later in the care pathway.
Specialty involvement also varied by disease stage. Interventional radiology predominated in early-stage disease, treating 51% of stage 0 and 48% of stage A patients, while medical oncology became the leading specialty in advanced stages, managing 73% of stage C and 77% of stage D cases. Notably, a subset of advanced-stage patients still received locoregional therapies, reflecting individualized treatment approaches.
Across sites, overall specialty distribution was similar, though transplant utilization was higher in Arizona (18%) compared with Minnesota (5%) and Florida (10%). Interventional radiology techniques varied by location, with thermal ablation comprising 37% of procedures overall, followed by transarterial embolization (33%) and radioembolization (28%).
“The consistent involvement of interventional radiology supports its role as a core tumor board discipline, while the early and sustained participation of medical oncology in intermediate and advanced disease suggests potential benefit from coordinated hepatology–medical oncology evaluation early in the disease course,” concluded the study authors.
Reference
Islam FZ, De La Garza-Ramos C, Majeed U, et al. Real-world analysis of multidisciplinary roles in the management of hepatocellular carcinoma: The Mayo Clinic experience. J Hepatocell Carcinoma. 2026;13:566609. doi:10.2147/JHC.S566609
