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Fatima Z Islam,1 Cynthia De La Garza-Ramos,1 Umair Majeed,2 Michael Rutenberg,3 Kris Croome,4 Liu Yang,5 Denise Harnois,5 Amit K Mathur,6 Lewis R Roberts,7 Tushar Patel,5 Robert J Lewandowski,8 Beau B Toskich1 1Department of Interventional Radiology, Mayo Clinic Florida, Jacksonville, FL, USA; 2Department of Hematology and Oncology, Mayo Clinic Florida, Jacksonville, FL, USA; 3Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL, USA; 4Department of Transplantation, Division of Transplant Surgery, Mayo Clinic Florida, Jacksonville, FL, USA; 5Department of Transplantation, Division of Transplant Medicine, Mayo Clinic Florida, Jacksonville, FL, USA; 6Department of Transplantation, Division of Transplant Surgery, Mayo Clinic Arizona, Scottsdale, AZ, USA; 7Department of Transplantation, Division of Transplant Medicine, Mayo Clinic, Rochester, MN, USA; 8Department of Radiology, Section of Interventional Radiology, Northwestern University, Chicago, IL, USACorrespondence: Beau B Toskich, Department of Interventional Radiology, Mayo Clinic Florida, 4500 San Pablo RoadS, Jacksonville, FL, 32224, USA, Tel +1 904-953-1496, Email toskich.beau@mayo.eduBackground: Hepatocellular carcinoma (HCC) is a complex disease best managed through multidisciplinary care, yet real-world patterns of medical specialty involvement remain poorly characterized. This study mapped specialty care pathways for HCC patients treated at the three Mayo Clinic destination medical centers.Methods: A retrospective review was performed using the Mayo Data Explorer for treatments delivered between May 2020 and May 2025. Patients with HCC were identified through diagnosis codes or hepatology consultation. Therapeutic events across interventional radiology (IR), medical oncology, transplant surgery, radiation oncology, and hepatopancreatobiliary surgery (HPBS) were analyzed descriptively by treatment line and Barcelona Clinic Liver Cancer (BCLC) stage.Results: Of 6051 HCC patients identified, 4799 met inclusion criteria. Hepatology provided consultation for 87% of patients (n=4183). For first-line treatments (n=3079), 37% received initial therapy from IR, 27% from medical oncology, 17% from transplant surgery, 10% from HPBS, and 9% from radiation oncology. IR remained the most common provider across subsequent treatment lines. Analyses were based on treatment events, and some patients contributed to multiple treatment lines. Among patients with documented BCLC stage (n = 906), IR most frequently delivered initial therapy for stages 0 and A, whereas medical oncology predominated for stages B and C. Locoregional therapies were used in 27% of BCLC C patients.Conclusion: This real-world mapping reveals IR as a procedural cornerstone within multidisciplinary HCC management, particularly for early-stage disease. Hepatology remains essential for initial patient evaluation and care coordination. Medical oncology predominates for intermediate-stage disease, while locoregional therapy continues to be used in a substantial proportion of advanced-stage cases. These findings highlight the complex and evolving role of subspecialties in the management of HCC and may inform future resource allocation and care strategies.Keywords: interventional radiology, medical oncology, radiation oncology, transplant, hepatopancreatobiliary surgery, hepatocellular carcinoma, multidisciplinary care