Real-World Treatment Patterns of Early-Stage Hepatocellular Carcinoma (HCC) after Complete Resection or Ablative Therapy: Retrospective, Medical Chart Review in the United States

OBJECTIVES:

This study aimed to describe real world characteristics and treatment patterns among patients with early-stage HCC who underwent curative resection or ablation.

METHODS:

A US-based, chart review study in patients with early-stage HCC was conducted. Eligible patients underwent complete resection or achieved a complete response after local ablation, were identified as high-risk for HCC recurrence by a physician and began post-resection or ablation follow-up between 01/01/16 and 12/31/18. Patients were followed until loss to follow up or end of study period (5/23/2022).

RESULTS:

Among 300 eligible patients, the majority were male (60.0%) and White (60.7%). Mean age at HCC diagnosis was 63.2 years and 86% were identified as BCLC stage A. All patients were physician reported as high-risk for recurrence, with the majority (80.0%) falling within high-risk criteria from CheckMate-9DX clinical trial. Approximately 59.0% and 41.0% underwent complete resection or local ablation, respectively. Median study follow-up time after resection or ablation was 21.6 months.

Among all patients, 26.7% (n=80) experienced HCC recurrence within the median study follow-up. Of the 80 patients experiencing recurrence, 56.3% had a metastatic recurrence, and 43.8% had a locoregional recurrence. The majority of patients with a recurrence received systemic therapy (61.3%), and about a quarter of patients received embolization treatments (21.3%). Among recurrent HCC patients who received systemic therapy, median duration of 1L therapy was 8.5 months.

CONCLUSIONS:

In this real-world study of patients with early-stage HCC who received curative resection or ablation and were clinician assessed as high-risk for recurrence, over a quarter of patients had a locoregional or metastatic recurrence during the 21.6 month median follow up period. These findings highlight the need for therapies to prevent recurrence in early-stage HCC patients after curative resection or ablation.