This section outlines how the data of MDV can be used by reviewing some cases.

Case Study (Epidemiology)

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

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 for each kind of HCC stage based on Barcelona Clinic Liver Cancer (BCLC) staging system but it is not well understood in Japan.

Objectives of the Study

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

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

Study Design and Criteria

Study Design: Retrospective Cohort Study

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

Inclusion Criteria

1. Patient who have both following criteria

• Had a definitive diagnosis of HCC

• ICD10 code: C220

• Had a history of diagnosis marker for HCC

• α‐fetoprotein (AFP)
• des‐γ‐carboxy prothrombin (DCP)

1. Have 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 sorafenib chemotherapy with (>) 180 days of follow-up period after definitive diagnosis of HCC

1. Have cancer stage data with primary HCC patients

Characteristics of Patients with Hepatocellular Carcinoma

Serum Laboratory Values and Child Pugh Scores

First-line Treatments for HCC Patients

Sankey Diagram of Treatment Flow for HCC Patients

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

Sankey Diagram of Treatment Flow for HCC Patients

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

Service used for the Case Study:

Abbreviations