Determination of quality of care for patients with hepatocellular carcinoma in Nova Scotia.

Abstract

506 Background: Hepatocellular carcinoma (HCC) is the most common primary malignancy found in the liver. Little is known about the outcomes of HCC patients in the province of Nova Scotia (NS). There is suggestion that closer proximity to tertiary cancer center provides better outcomes for HCC patients. We postulate that cancer care for HCC patients differs based on a patient’s accessibility to an academic cancer care center. Methods: A retrospective chart review of HCC patients diagnosed from 2015 to 2017, looking at referrals patterns, treatments and wait time was undertaken. Patients who live within the urban area of Halifax, NS (N = 97), where the academic cancer center is, was compared to patients who live outside Halifax (rural, N = 70). Results: 167 patients were identified with a diagnosis of HCC, which included 139 males and 28 females with median age of 68 years old at HCC diagnosis. During that period, only 35.3% of patients diagnosed with HCC had a tissue diagnosis and 67.7% had a baseline AFP (16% had an AFP > 400). Just over 76% were diagnosed based on clinical features. Surgical intervention occurred in 15.6% and local treatments including radiation and TACE occurred in 35.3% of patients .Referral rate to Medical Oncology (MO) was 37.7%, of which 34.1% of patients had seen a MO at the time of data cut off (09-15-2019). 22 patients were eligible for systemic therapy but only 14 patients received systemic treatment (sorafenib n = 14). Conclusions: Initial data suggests patients who live in Halifax appear to have better outcomes than those outside. Further analysis is required to identify what differs between the urban and rural centers accounting for the seen difference in survival. [Table: see text]