Risk factors, treatment patterns and survival of patients with incident hepatocellular carcinoma in France: A retrospective data analysis.

Abstract

284 Background: Despite the screening of patients at risk, hepatocellular carcinoma (HCC) is often diagnosed at an advanced stage disease, with a very poor prognosis. Aim: To describe risk factors, treatment patterns and survival of patients with newly diagnosed HCC in France over the period 2015-2017 using SNDS, the national administrative healthcare database covering around 99% of the population. Methods: The database was searched for patients with a diagnosis of HCC (ICD-10: C220) from 1 January 2015–31 December 2017. Disease stage (Barcelona Clinic Liver Cancer B, C or D classification) was defined by the identification of treatment: transcatheter arterial chemoembolization (TACE) or radioembolization (TARE), HCC systemic therapy and/or best Supportive Care (BSC). Patients were followed up for a maximum of 2 years. Results: 21,071 patients were identified, mean age 69.2 years (SD: 11.1), 82.2% were male. Liver disease or diabetes was identified in 86.4% of patients. The most frequent risk factors were alcohol liver disease (42.7%), viral hepatitis and alcohol liver disease (7.2%), viral hepatitis alone (12.6%), NASH/NAFLD or diabetes (17.7%). At diagnosis, 6,571 (31.2%) received a curative HCC treatment. Within the total population, 8,616 patients (40.9%) were only managed by BSC, 6,571 (31.2%) received a treatment therapy, of which 3,184 (15.1%) had a TACE or TARE and 2 700 (12.8%) sorafenib. The 1-year survival rates by initial treatment were: curative (88.7%), TACE or TARE (70%), systemic therapy (32.2%) and only 17.8% with BSC. Conclusions: These results show the high burden of HCC, with more than two thirds of patients not receiving active treatment.