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Aim To assess the effect of surgery, chemotherapy, and radiation on the mortality risk in hepatocellular carcinoma (HCC) patients. Method A retrospective cohort study, obtaining HCC patients' data from the Surveillance, Epidemiology, and End Results (SEER) database. We used Pearson's chi-square test for evaluating the association between the different variables, the Kaplan–Meier, and the Cox regression tests in the univariate and multivariate analyses respectively. Results A total of 68270 HCC patients were analysed. In patients who performed surgery, the mortality risk was higher in patients aged ≥50 years, Black, single, and widowed, regional, and distant stages, and grades II, III, and IV (HR, 1.143), (HR, 1.057), (HR, 1.095), (HR, 1.284), (HR, 1.341), (HR, 2.291), (HR, 1.125), (HR, 1.711), and (HR, 1.894) respectively. In patients who received chemotherapy, the risk was lower in females (HR, 0.948), but higher in widowed (HR, 1.143), in regional and distant stages (HR, 1.479), and (HR, 2.439) respectively, and grades III, and IV (HR, 1.741), and (HR, 1.688) respectively. In patients who received beam radiation, the risk was higher in Black (HR, 1.195), widowed (HR, 1.181), regional (HR, 1.439), and distant stages (HR, 2.287), and in grades III (HR, 1.594), and IV (HR, 1.694). Conclusions In HCC patients, Black, widowed, regional, and distant stages, grades III and IV had higher mortality risks in several treatment options. In patients who underwent surgery, ≥50 years years and grade II also had a higher risk. We recommend future research to assess the radiation sequence with surgery.

63 Effects of Surgery, Chemotherapy, and Radiation on Hepatocellular Carcinoma Patients: A SEER-Based Cohort study