OBJECTIVES

To systematically identify and assess published, peer-reviewed utility data for patients with advanced or metastatic hepatocellular carcinoma (HCC).

METHODS

Comprehensive searches were conducted in major electronic databases, and supplemented by searching congress abstracts and Health Technology Assessment websites on 5^th March 2018. No publication date limits were applied but reviews, editorials and non-English language publications were excluded.

RESULTS

A total of eight studies, three randomised controlled trials (RCTs) reporting treatment-specific utilities (0=dead, 1=full health) and five observational studies reporting disease-specific utilities, were included. There was a marked difference in utilities recorded in RCTs (0.67-0.87) compared to observational studies (0.31-0.72). Four studies reported utilities for HCC in the presence of other comorbid conditions including hepatitis C infection (0.51-0.72 elicited from Canadian patients), hepatitis B infection (0.38 from international patient population), and chronic hepatitis B (0.72 from Chinese patients). No other studies reported utilities by HCC severity except a South Korean-based observational study by Ock et al. that reported greater utility scores for the first-line treatments (liver transplantation=0.67, partial hepatectomy=0.61) compared to care for advanced disease stage (palliative therapy=0.39, non-surgical treatment=0.54). Five out of eight studies used EQ-5D for utility elicitation. Identified HCC-specific utility data ranged between 0.31-0.87, though there was notable heterogeneity in the data. Variation was noted in terms of study design, patient population, disease states, and methods of utility elicitation. Nevertheless, some observed trends were consistent across the literature: utilities were greater for milder conditions (e.g., CHB without complications, compensated cirrhosis, patients requiring first-line therapy) than severe conditions (decompensated cirrhosis, advanced HCC).

CONCLUSIONS

Overall, there is a paucity of utility data for patients with HCC, which makes drawing further conclusions difficult. Further research is needed, to better understand the impact of the disease on patient quality of life and the potential benefit therapies may offer.