Case-01 : Epidemiology

This section outlines how the data of MDV was able to be utilized in past cases.

Case Sample (Epidemiology)

Database Analysis of Patients with Hepatocellular Carcinoma and Treatment Flow in Early and Advanced Stages

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Akada K, Koyama N, Taniguchi S, et al. Database analysis of patients with hepatocellular carcinoma and treatment flow in early and advanced stages [J]. Pharmacol Res Perspect. 2019;7(4):e00486.

Introduction

  • Prognosis of advance hepatocellular carcinoma (HCC) is not as developed when compared to treatment modalities and diagnosis in Japan.
  • Different treatment flows are seen in each kind of HCC stage based on Barcelona Clinic Liver Cancer (BCLC) staging system but is not well understood in Japan.

Objective of Study

To understand the following content by utilizing real world data from Japanese claim database.

  • 1Baseline characteristics and treatment flow of HCC patients;
  • 2Variances in treatments between early and advanced stages;
  • 3Impact of tumor stage progression

Study Design and Criteria

Study Design: Retrospective Cohort Study

Target Period: April 1, 2008 – January 31, 2017

Inclusion Criteria

  • 1Patient who have both following criteria
  • a.Patients who had definitive diagnosis of HCC
  • ICD10 code: C220
  • b.Had a history of diagnosis marker for HCC
  • α‐fetoprotein (AFP)
  • des‐γ‐carboxy prothrombin (DCP)
  • 2Have one of the following treatments
  • Transcatheter arterial chemoembolization (TACE)
  • Transcatheter arterial embolization (TAE)
  • Hepatectomy
  • Radiofrequency ablation (RFA)
  • Percutaneous ethanol injection (PEI)
  • Hepatic arterial infusion chemotherapy (HAIC)

OR

Have sorafebib chemotherapy within under (>) 180 days of follow-up period after definitive diagnosis of HCC

  • 3Have cancer stage data with primary HCC patients

Characteristics of Patients with Hepatocellular Carcinoma

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Serum Laboratory Values and Child Pugh Scores

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First‐line Treatments for HCC Patients

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Sankey Diagram of Treatment Flow for HCC Patients

Change of treatments from first to fourth‐line were observed in early (A) stages

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Sankey Diagram of Treatment Flow for HCC Patients

Change of treatments from first to fourth‐line were observed in advanced (B) stages

case_studies01_img_07.png

Conclusion

  • Was able to pinpoint the clear differences in baseline characteristics and treatment flow between early and advanced stages.
  • Further analysis could be considered and beneficial regarding treatment selection and forecasting outcome such as survival with longer follow-up data on the database utilized for this study.

Service Utilized for Case Study:

Abbreviation

  • BCLCBarcelona Clinic Liver Cancer
  • HAICHepatic arterial infusion chemotherapy
  • HBVHepatitis B virus
  • HCCHepatocellular carcinoma
  • HCVHepatitis C virus
  • RFARadiofrequency ablation
  • TACETranscatheter arterial chemoembolization

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