OBJECTIVES: Despite significant improvements with resection and ablative therapies in early-stage HCC, high rates of recurrence still exist. No effective adjuvant therapies are yet available, which remains a major unmet need. A SLR was conducted to collect and evaluate the economic and humanistic evidence in early-stage HCC.

METHODS: The SLR (2 reviewers; quality assessment) identified economic evaluations, healthcare costs resource use (HCRU) and quality of life (QoL) studies from MEDLINE, Embase, EconLit, PsychINFO, NHS EED, HTA database, HTA websites and conferences. The SLR was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews of Interventions.

RESULTS: Of the 3,149 records retrieved, a total of 37 publications provided recent economic and humanistic burden evidence in the (post-) resection or ablation setting. These 37 publications presented nine economic evaluations, 11 HCRU studies, 14 QoL studies, and three HCRU/QoL studies. Studies were conducted across all continents, but most frequently in Asia (n=25). Most economic evaluations used a Markov model structure (n=6) with four to nine health states. The cost-effectiveness of three adjuvant antiviral therapies was assessed, the other evaluations compared different types of surgery and/or ablative therapies. HCRU studies reported heterogeneous data for drugs and medical/surgical procedures used, inpatient and outpatient visits and overall healthcare costs. QoL was evaluated using the SF-36 (n=9), FACIT/FACT (n=6), EORCT-QLQ-C30/HCC18 (n=3), and an undisclosed QoL instrument (n=1).

CONCLUSIONS: Economic and humanistic evidence in early-stage HCC was available, however the majority was associated with surgery or ablative therapies. Limited evidence was available for adjuvant treatment post-surgery or ablation, as there is no guideline recommended treatment available in the adjuvant setting.