Patient Pathways and Healthcare Resources Use in Hepatocellular Carcinoma: Full Analyses of the OPAL Study in Portuguese Population

Speaker(s)

Moital I1, Gaspar R2, Serrazina J3, Bronze S3, Carvalhana S3, Fonseca C4, Matos A5, Simão A5, Carvalho A5, Fernandes B6, Melita C6, Pereira S6, Silva AS6, Vieira J6, Presa J6, Ribeiro M7, Macedo J7, Machado M7, Roque R8, Santos R8, Coelho AR8, Matos R8, Bonito N8, Fernandes M9, Muller S9, Sousa M9, Macedo G2, Mansinho H4, Pinto AR1, Fonseca F1, Bernardo F1
1AstraZeneca, Barcarena, Portugal, 2Unidade Local de Saúde de São João, EPE, Porto, Portugal, 3Unidade Local de Saúde de Santa Maria, EPE, Lisbon, Portugal, 4Unidade Local de Saúde de Almada-Seixal, EPE, Almada, Portugal, 5Unidade Local de Saúde de Coimbra, EPE, Coimbra, Portugal, 6Unidade Local de Saúde de Trás-os-Montes e Alto Douro, EPE, Vila Real, Portugal, 7Unidade Local de Saúde de Entre Douro e Vouga, EPE, Santa Maria da Feira, Portugal, 8Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Coimbra, Portugal, 9Serviço de Saúde da RAM, EPERAM - Hospital Dr. Nélio Mendonça, Funchal, Ilha da Madeira, Portugal

Presentation Documents

OBJECTIVES: Hepatocellular carcinoma (HCC) disease management evidence in Portugal is limited. OPAL aimed to present the patient pathway for HCC and healthcare resources utilization (HRU) in Portugal.

METHODS: Pan-European, non-interventional, longitudinal, multi-center, cohort study to characterize adult patients with newly diagnosis HCC from 01Jan2018 to 31Dec2021. Data was collected retrospectively from diagnosis until 31Dec2022 (end of study), lost to follow-up (LTFU) or death. Informed consent was collected for alive patients.

RESULTS: The final cohort included 290 patients. The majority were male (n=252; 87%) with mean age of 67 ± 9.5 years.

Most patients had non-curative terminal stage disease, BCLC B-D (n=144/207;70%). At diagnosis, cirrhosis was identified in 231 patients (80%), with 71% (n=152) presenting compensated disease. Nonetheless, 78% of patients of the terminal stage cohort presented decompensated cirrhosis. Alcohol use was the most frequent etiology (n=211; 73%). Clinically significant portal hypertension (n=97;33%;), esophageal varices (n=95; 33%), and ascites (n=83, 29%) were the most frequent disease complications

Hepatologists performed most HCC diagnosis (n=129, 41%), with 20% of patients (n=57) referred from other healthcare units mainly from primary care institutions (n=31, 54%). Signs/symptoms were poorly reported (n=68; 23%), mostly within non-curative/terminal stage cohort (n=54; 79%) with a mean time of 0-8.6 months between report and diagnosis.

All patients experienced at least two hospitalizations with an average length of 8 days. Most common reasons for hospitalizations were liver disease complications management and/or locoregional procedures performance (n=372/619; n=60%), disease progression (n=212/619; 34%) or treatment related toxicities/adverse events (n=28/619; 5%).

Non-curative disease/terminal stage cohort was associated with longer hospitalizations (+2 days) comparing with patients diagnosed at early stages.

CONCLUSIONS: Our findings demonstrate that most non-curative HCC patients present in a hospital setting with advanced disease, often lacking reported signs/symptoms. Late HCC diagnosis significantly impacts HRU. This highlights the need to improve HCC management optimization and effective screening programs development.

Code

HSD125

Disease

Oncology