Abstract 3773
Background
It is internationally recognised that centralisation of specialist cancer services results in improved oncologic outcomes, particularly for rare cancers. Ireland’s oncology services were formally centralised into 8 high volume cancer centres in 2007. We sought to identify changes in the utilisation of cancer treatment modalities and outcomes for patients with hepatobiliary cancers in Ireland pre and post centralisation.
Methods
Following local ethics board approval, anonymised patient data was provided by the National Cancer Registry of Ireland (NCRI) regarding all cases of hepatocellular cancer (HCC), cholangiocarcinoma and gallbladder cancers (ICD10: C22, C23 and C24) diagnosed in Ireland between 2000 – 2016. Data analysis was completed in collaboration with the NCRI.
Results
Data from 5733 patients with cholangiocarcinoma, gallbladder cancer and HCC over 16 years were analysed (Table). Similar rates of resection of all cancers were identified (21% pre 2008 and 24% from 2008 -2016). Overall 5-year survival for all cancers evaluated was significantly higher (non-overlapping CI) from 2008 -2016 - 16.1% (95% CI 14.4-17.8%) compared to pre 2008 - 12.6% (95% CI 11.0-14.4%). Despite similar rates of resection, 5-year survival rates for all resected cancers was significantly improved from 2008 - 2016 - 46.0% (95% CI 41.3-50.6%) vs 35.7% (95% CI 30.7-40.6%) prior to this. The most significant changes in use of treatment modality over the time course studied was the number of patients who received chemotherapy only (9% pre 2008 and 19% 2008 -2016, p < 0.01) and the significant increase in the number of patients who underwent adjuvant treatment (21% pre 2008 versus 42% from 2008 - 2016, p < 0.01).Table:
740P
Cancer Subtypes | 2000-2007 | 2008-2016 |
Cholangiocarcinoma | 38% (782) | 41% (1519) |
Hepatocellular Carcinoma | 17% (346) | 21% (780) |
Gallbladder | 19% (379) | 13% (497) |
Unspecified Subtype | 26% (537) | 24% (893) |
Total | 2044 | 3689 |
Conclusions
The establishment of national cancer centres in Ireland in 2007 was associated with improvement in 5-year survival for patients with hepatobiliary malignancies and with increased utilisation of systemic therapy in the advanced and adjuvant settings.
Clinical trial identification
Editorial acknowledgement
We would like to thank all the team at the National Cancer Registry of Ireland for their hard work collecting the data.
Legal entity responsible for the study
St. James’ Hospital, Dublin.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
4413 - Infigratinib versus gemcitabine plus cisplatin multicenter, open-label, randomized, phase 3 study in patients with advanced cholangiocarcinoma with FGFR2 gene fusions/translocations: the PROOF trial
Presenter: Ghassan Abou-Alfa
Session: Poster Display session 2
Resources:
Abstract
4710 - Phase 3 (COSMIC-312) study of cabozantinib (C) in combination with atezolizumab (A) vs sorafenib (S) in patients (pts) with advanced hepatocellular carcinoma (aHCC) who have not received previous systemic anticancer therapy
Presenter: Lorenza Rimassa
Session: Poster Display session 2
Resources:
Abstract
5509 - A Randomized Controlled, Open label, Adaptive Phase-3 Trial to Evaluate Safety and Efficacy of EndoTAG-1 Plus Gemcitabine versus Gemcitabine alone in Patients with Measurable Locally Advanced and/or Metastatic Adenocarcinoma of the Pancreas Failed on FOLFIRINOX Treatment (NCT03126435)
Presenter: Li-Tzong Chen
Session: Poster Display session 2
Resources:
Abstract
1463 - Modified FOLFOX versus modified FOLFOX plus nivolumab and ipilimumab in patients with previously untreated advanced or metastatic adenocarcinoma of the stomach or gastroesophageal junction – Moonlight, a randomized phase 2 trial of the German Gastric Group of the AIO.
Presenter: Sylvie Lorenzen
Session: Poster Display session 2
Resources:
Abstract
2392 - GLOW: Randomized Phase 3 Study of Zolbetuximab + CAPOX Compared With Placebo + CAPOX as First-line Treatment of Patients With CLD18.2⁺/HER2⁻ Locally Advanced Unresectable or Metastatic Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma
Presenter: Manish Shah
Session: Poster Display session 2
Resources:
Abstract
5217 - PRODIGE67_UCGI33 ARION: Association of Radiochemotherapy and Immunotherapy for the treatment of unresectable Oesophageal caNcer: a comparative randomized phase II trial
Presenter: Rosine Guimbaud
Session: Poster Display session 2
Resources:
Abstract
1726 - Randomized phase II trial of weekly paclitaxel + ramucirumab versus weekly nab-paclitaxel + ramucirumab for unresectable advanced or recurrent gastric cancer with peritoneal dissemination refractory to first-line therapy: WJOG10617G/P-SELECT
Presenter: Kenro Hirata
Session: Poster Display session 2
Resources:
Abstract
2279 - FRONTiER: A Feasibility Trial of Nivolumab With Neoadjuvant CF or DCF Therapy for Locally Advanced Esophageal Carcinoma
Presenter: Shun Yamamoto
Session: Poster Display session 2
Resources:
Abstract
4912 - A phase Ib/II study of AK104, a PD-1/CTLA-4 Bispecific Antibody, Combined With mXELOX as First-line Therapy for Advanced Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma
Presenter: Jiafu Ji
Session: Poster Display session 2
Resources:
Abstract
3780 - Perioperative atezolizumab in combination with FLOT versus FLOT alone in patients with resectable esophagogastric adenocarcinoma: DANTE, a randomized, open-label phase II trial of the German Gastric Group of the AIO and the SAKK.
Presenter: Salah-Eddin Al-Batran
Session: Poster Display session 2
Resources:
Abstract