Over the last 4 decades, advances in surgical techniques, locoregional therapy imaging, and systemic therapy have significantly improved overall survival (OS) in hepatocellular carcinoma (HCC).1 HCC’s complex nature, influenced by tumor burden, liver function/portal hypertension, and performance status, emphasizes the need for a multidisciplinary approach to enhance outcomes. Serper et al2 report factors that influenced the delivery of active HCC therapy and OS in 3988 HCC patients diagnosed between January 1, 2008 and December 31, 2010, at 128 Veteran’s Affairs (VA) medical centers, with follow-up through December 31, 2014.