Treatment patterns, risk factors and outcomes for patients with newly diagnosed hepatocellular carcinoma in France: A retrospective database analysis.
Epidemiology
France
Hepatocellular carcinoma
Risk factors
Survival
Journal
Clinics and research in hepatology and gastroenterology
ISSN: 2210-741X
Titre abrégé: Clin Res Hepatol Gastroenterol
Pays: France
ID NLM: 101553659
Informations de publication
Date de publication:
05 2023
05 2023
Historique:
received:
20
12
2022
revised:
21
03
2023
accepted:
12
04
2023
medline:
1
5
2023
pubmed:
16
4
2023
entrez:
15
4
2023
Statut:
ppublish
Résumé
The aim of this analysis was to describe the nationwide distribution of patients with newly diagnosed hepatocellular carcinoma (HCC) according to treatment patterns, aetiologies, and outcomes in France. A retrospective cohort of patients with newly diagnosed HCC was selected over the period 2015-2017 in a French claims database covering 99% of the population. Treatment patterns were described using an algorithm based on a ranking of curative and palliative HCC treatments identified. Survival was analyzed using Kaplan-Meier curves according to major treatments and aetiologies. A total of 20,083 incident patients were identified with a mean age of 69.2 years (SD: 11.0) and 82.4% of men. The mean duration of follow-up was 10.0 months (SD: 9.7). At least one HCC risk factor could be identified in 87.0% of patients. The most frequent aetiologies were alcohol-related liver disease present in 50.8% of patients, a metabolic disease (NAFLD, NASH or diabetes) without alcohol or viral hepatitis (44.5%) and viral hepatitis (20.0%). Only 32.7% of patients received a curative therapy, with a 1-year survival of 89.5%, while 38.0% of patients received only best supportive care, with a 1-year survival of 12.9%. The highest rates of curative treatments were found in patients with viral hepatitis, associated or not with another risk factor. Hepatocellular carcinoma was still most often diagnosed at an advanced disease stage as shown by the low rate of curative treatment observed and the very poor prognosis. Viral aetiology was associated with the best survival.
Sections du résumé
BACKGROUND & AIMS
The aim of this analysis was to describe the nationwide distribution of patients with newly diagnosed hepatocellular carcinoma (HCC) according to treatment patterns, aetiologies, and outcomes in France.
METHOD
A retrospective cohort of patients with newly diagnosed HCC was selected over the period 2015-2017 in a French claims database covering 99% of the population. Treatment patterns were described using an algorithm based on a ranking of curative and palliative HCC treatments identified. Survival was analyzed using Kaplan-Meier curves according to major treatments and aetiologies.
RESULTS
A total of 20,083 incident patients were identified with a mean age of 69.2 years (SD: 11.0) and 82.4% of men. The mean duration of follow-up was 10.0 months (SD: 9.7). At least one HCC risk factor could be identified in 87.0% of patients. The most frequent aetiologies were alcohol-related liver disease present in 50.8% of patients, a metabolic disease (NAFLD, NASH or diabetes) without alcohol or viral hepatitis (44.5%) and viral hepatitis (20.0%). Only 32.7% of patients received a curative therapy, with a 1-year survival of 89.5%, while 38.0% of patients received only best supportive care, with a 1-year survival of 12.9%. The highest rates of curative treatments were found in patients with viral hepatitis, associated or not with another risk factor.
CONCLUSION
Hepatocellular carcinoma was still most often diagnosed at an advanced disease stage as shown by the low rate of curative treatment observed and the very poor prognosis. Viral aetiology was associated with the best survival.
Identifiants
pubmed: 37061035
pii: S2210-7401(23)00049-9
doi: 10.1016/j.clinre.2023.102124
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
102124Informations de copyright
Copyright © 2023. Published by Elsevier Masson SAS.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Philippe Mathurin: MSD, Ipsen, Eisai, Abbvie, Sanofi, Gilead Sciences, Pfizer, Evive Biotech, Novo Nordisk, Bayer Healthcare, Surrozen, Intercept; Marie de Zélicourt: Employee of CEMKA; Caroline Laurendeau: Employee of CEMKA; Manel Dhaoui: Employee of Ipsen; Nadia Kelkouli: Employee of Ipsen; Jean Frédéric Blanc: Bayer, ESAI, MSD, IPSEN, Roche, Astra-Zeneca, BMS, AMGEN.