61 Background: The global incidence of HCC is over 700,000 patients making it the sixth leading cancer. Recently new drugs have been approved to treat HCC. Nevertheless, prognosis is poor with a 5 year survival of 11%. Hence, it is important to understand if there are differences in OS in the Real World (RWE) based on patient demographics, comorbidities and whether current treatments are effective. Methods: A robust global database of HCC patients was constructed from patient chart data with nearly 4,000 unique patient records from the United States, the European Union, and Asia in 2011. Several hypotheses were tested including the impact of ethnicity, presence of Hep B or C or cirrhosis, stage at diagnosis and/or if current treatments used could predict PFS and /or OS. CART and CHAID analyses were conducted to help determine patient segments and treatment flows in conjunction with Kaplan-Meier plots to understand the differences in survival based key patient and treatment attributes. Results: One year survival appears to be associated with geography as it is significantly lower in China/ Korea compared to the United States and the European Union. Significantly higher one year survival rates are observed for HCC patients in the European Union and the United States receiving TACE compared with patients receiving sorafenib first line. However, in Asia there are no differences. Across all three regions sorafenib use does not effect OS in Stage IV patients. Further, no significant differences in one year survival are seen in patients with Hep C or B or cirrhosis compared to those with no history of liver disease. Sorafenib treatment duration in China appears to be substantially lower. Finally, Child-Pugh C patients had lower survival compared to Child-Pugh A or B patients. Conclusions: Early diagnosis, intervention and treatment of HCC appear to be important predictors of survival. Stratifying groups by type of drug treatment including sorafenib use does not appear to have a measurable effect on OS. Efforts aimed towards screening, early detection and treatment initiation during early stages to improve RWE for HCC patients may be more effective than expanding treatment with sorafenib in late stage patients. Given the lack of significance in OS for late stage patients treated with sorafenib across the globe, serious thought should be given its use for late stage patients.
e14640 Background: The global incidence of HCC is over 700,000 patients making it the sixth leading cancer and the prognosis is poor with a 5 year survival of 11%. It is important to understand if there are differences in survival based on the presence of Hepatitis B or C or alcohol cirrhosis, ethnicity and/or treatments employed in various stages of the disease. Methods: A robust global retrospective study of HCC patients was conducted with nearly 4,000 patient records from US, Germany, France, Spain, Italy, China and South Korea in 2011. Of these nearly 800 included deceased patients. These records were analyzed to study if any known factors such as ethnicity, presence of Hepatitis B, Hepatitis C or alcohol cirrhosis and/or treatments used at diagnosis could serve as predictors for survival. Kaplan-Meier curves were plotted to understand the differences in survival based on ethnicity, Child-Pugh status and treatments employed at various stages. Results: One year survival is lower in China/ Korea compared to US and EU, however, five year survival rates are comparable across regions. Associated hepatitis or cirrhosis does not convey any differences in one year survival whether patients received sorafenib as first line treatment or not. Statistically significant higher one year survival rates are observed for HCC patients in Europe and USA receiving transarterial chemoembolization (TACE) compared with patients receiving sorafenib first line. However, in China and Korea there is no such difference. Across all three regions: USA, EU and Asia there is no difference in survival in stage IV patients receiving sorafenib or no sorafenib. No significant differences in one year survival are seen in USA, EU and Asia for patients with Hepatitis C or B or cirrhosis compared to those with no history of liver disease. The Child-Pugh C patients had lower survival compared to Child-Pugh A or B patients. Conclusions: Early diagnosis of HCC, early intervention and treatment appear to show survival benefits as opposed to drug treatment with sorafenib initiated in the later stages of the disease. Efforts should increase for screening, early detection and treatment initiation at early stage to improve outcomes in HCC patients.
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