P41 A decade of trends at a regional HCC MDT: increasing patient numbers and treatment modalities

<h3>Introduction</h3> Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and is a leading cause of cancer death. A range of treatment options exist, including various systemic anti-cancer therapies (SACT) which have increased in availability over the last decade. As such, a multi-disciplinary team (MDT) approach to diagnosis and individualised treatment is recommended. <h3>Methods</h3> We undertook a retrospective analysis of patients being discussed at the regional West of Scotland HCC MDT. All patients discussed at the MDT from April to June 2014, 2018 and 2022 were analysed. The total number, reason for discussion (new or return), time to and type of treatment, and survival time was compared across groups. Chi-squared, Mann-Whitney U and Kaplan-Meier survival analysis were used in statistical analysis. <h3>Results</h3> The number of patients being discussed increased across the three time periods (2014 n=63, 2018 n=102, 2022 n=116), with an increasing proportion of return patients after 2014 (2014=33%, 2018=47.6%, 2022=51.7%, p=&lt;0.05). The number of new diagnoses was broadly similar (2014 n=39, 2018 n=38, 2022 n=40). The proportion of patients recommended for best supportive care (BSC) decreased from 46% in 2014 to 39.5% in 2018 and 37.5% in 2022 (p&lt;0.05). First line SACT increased from 5% in 2014 to 13.2% in 2018 and 15% in 2022(p&lt;0.05), representing an increase in availability and eligibility. In 2014, median time to treatment from diagnosis was 98 days, falling to 46 days in 2018 (p=0.02) but rising to 97 days in 2022. The proportion of patients undergoing more than one treatment modality (chemo-embolisation, ablation, resection, transplant and SACT) was similar between 2014 and 2018, but increased from 30.5% in 2018 to 47.4% in 2022 (p&lt;0.05). There was no difference in survival between the 2014 and 2022 cohorts with 1-year mortality rates of 48.7% and 52.5% respectively (figure 1). <h3>Conclusion</h3> In less than a decade, the number of patients discussed at the West of Scotland regional HCC MDT has almost doubled (increased by 84%), with a significant increase patients returning for repeat discussion, and proportion of patients receiving more than one treatment modality. Despite the reduction in patients recommended to receive best supportive care, there is not yet a survival benefit in our cohort. The MDT resulted in significant reduction in waiting times for treatment prior to the covid-19 pandemic, but subsequent waiting time increases reflect the general situation across healthcare systems.