Comprehensive Liver Cancer Center Approach to Improve Treatment Lag Time in Patients with Hepatocellular Cancer: A Tertiary Center Experience

Abstract

Background: Hepatocellular carcinoma (HCC) is a leading cause of death among patients with liver disease. A new Comprehensive Liver Cancer Center (CLCC) was established at our institution that adopted a same-day, single-visit approach to formulate a plan of care and expedite interventions. Methods: We retrospectively reviewed charts of patients diagnosed with HCC before and after the establishment of the CLCC. The cohort was divided into two groups: those who received care prior to (group 1) and after (group 2) the establishment of the CLCC. TL-T was calculated from the date of diagnosis to the date of the first therapeutic intervention and compared using a t-test. TL-T was compared using a t-test, other variables were compared using Fisher’s exact, and chi-square tests. Results: From the total cohort: 117 (40%) were in group 1 and 172 (60%) in group 2. Mean distance traveled by patients to seek care was 12.64 vs 16.06 miles, for groups 1 and 2 respectively. A larger number of patients presented within Milan criteria in group 2. Mean TL-T improved significantly after the implementation of CLCC; 152 to 69 days. Despite not reaching statistical significance, there was a decrease in the 1-year mortality in group 2 compared to group 1 (17% vs 11%, p= 0.16) respectively. Conclusion: A multidisciplinary approach is critical in the management of HCC. While the data did not suggest a significant change in secondary outcomes thus far, it demonstrated that our institution’s new CLCC was able to significantly reduce TL-T ensuring potentially better outcomes.