In China, traditional Chinese medicine (TCM) is commonly employed as a therapeutic approach for primary liver cancer (PLC). This study explored how TCM influences patient survival by assessing the correlation between the proportion of treatment time devoted to TCM—termed the treatment-duration ratio (C-TDR, calculated as the duration of TCM therapy divided by the total treatment period, multiplied by 100%)—and the survival outcomes of 1,002 individuals diagnosed with PLC. A total of 1,002 primary liver cancer (PLC) patients treated at the TCM Oncology Department of Changhai Hospital between January 2015 and December 2019 were included in this study. To determine independent prognostic factors for survival at various disease stages and to assess the impact of the TCM treatment-duration ratio (C-TDR) on survival, analyses were performed using univariate and multivariate Cox regression models, as well as propensity score matching (PSM). Cox regression analysis revealed that C-TDR was an independent prognostic factor for overall survival (P < 0.05), associated with a 75.67% reduction in the relative risk of death (RR = 0.2433; 95% CI = 0.1747–0.3388). This prognostic significance was also observed across all disease stages (P < 0.05). Among the 251 patients in the BCLC-A stage, C-TDR was associated with a 96.09% lower risk of mortality (RR = 0.0391; 95% CI = 0.0151–0.1012), while the 396 patients in BCLC-B experienced an 81.24% reduction in death risk (RR = 0.1876; 95% CI = 0.1112–0.3163). In stage C, comprising 355 patients, the risk of death decreased by 51.36% (RR = 1.0016; 95% CI = 0.9885–1.0149). Significant differences were observed in median overall survival between patients with higher versus lower C-TDR. Furthermore, after propensity score matching, survival outcomes remained significantly improved in the higher C-TDR group across all disease stages. Timely use of traditional Chinese medicine appears to decrease the risk of death and improve survival outcomes in liver cancer."
