Abstract 186P
Background
Liver transplantation (LTx) is a treatment option performed with curative intent in eligible patients with non-resectable hepatocellular carcinoma (HCC). To date, only very limited data specifically regarding the characteristics and outcomes of German patients undergoing LTx for HCC are available, and a cost analysis is lacking. This study aims at providing information to close this data gap.
Methods
The cohort comprised incident patients with documented HCC ≥18 years (y) undergoing LTx between 2016-2020 (ICD C22.0) from claims data of the BARMER-statutory health insurance. Patients with malignancies within 5 y prior to HCC-diagnosis were excluded. Patient characteristics, resource consumption, and costs related to peri- and post-LTx hospital stay were determined from the third-party payers’ perspective. Results were reported by descriptive statistics, survival was analyzed using the Kaplan-Meier method.
Results
Out of the 2778 patients with HCC, 65 patients (2%) underwent LTx (74% male; mean age 59.9 [standard deviation [SD] ±6.6]). The age distribution was as follows: <60y: 43%, 60-69y: 54%, ≥70y: 3%. The most frequently documented HCC-related risk factors were liver fibrosis/cirrhosis (91%), diabetes (75%), obesity (54%), and alcohol consumption (54%). Median time from HCC-diagnosis to LTx was 8.5 months. Survival rates were 79% at 3 y and 65% at 5 y post-LTx. The mean hospital length of stay within the first year since LTx was 52 days (SD±47) associated with mean per-patient costs of Euro 83,800 (SD±68,200). The total costs for the 65 LTx-patients were Euro 5.4 million.
Conclusions
To our knowledge, this is the first study reporting real world data on patients’ characteristics, survival, and LTx-associated costs in patients with HCC in Germany. 5-y survival is in line with the expected rates in patients selected according to the current criteria for transplantation. The large proportion of the working-age population highlights the societal burden associated to productivity losses due to HCC but underscores the potential of transplantation in restoring productivity and social participation for patients with HCC.
Legal entity responsible for the study
The authors.
Funding
Roche.
Disclosure
W. Hofmann: Financial Interests, Personal, Advisory Role: Ipsen, Falk Pharma, Novo Nordisk, Norgine, Gilead, Roche; Non-Financial Interests, Personal, Training: AbbVie, Gilead; Financial Interests, Personal, Invited Speaker: AbbVie, Gilead, Falk Pharma, Advanz Pharma. E.N. De Toni: Financial Interests, Personal and Institutional, Advisory Role: AstraZeneca, Bayer, BMS, Eisai, Eli Lilly & Co., Pfizer, Ipsen, Roche; Non-Financial Interests, Personal and Institutional, Training: Arqule, AstraZeneca, BMS, Bayer, Celsion, Roche; Financial Interests, Personal and Institutional, Invited Speaker: BMS, Falk; Financial Interests, Institutional, Research Grant: Arqule, AstraZeneca, BMS, Bayer, Eli Lilly & Co., Roche; Financial Interests, Personal, Full or part-time Employment: Boehringer-Ingelheim. N. Ben Khaled: Non-Financial Interests, Personal and Institutional, Training: Eisai; Financial Interests, Personal and Institutional, Invited Speaker: Falk, AstraZeneca. K. Berger-Thürmel: Financial Interests, Institutional, Research Grant: Roche. All other authors have declared no conflicts of interest.