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Introduction <p>Patients with early-stage hepatocellular carcinoma (HCC) who undergo curative-intent therapy remain at risk of disease recurrence. This study aimed to quantify the economic burden associated with disease recurrence in these patients.</p> Methods <p>Patients ≥ 66&#xa0;years old with early-stage HCC who have achieved complete radiological response via surgical resection or local ablation were selected from the SEER–Medicare database (2007–2017). Patients with evidence of recurrence following complete radiological response with curative-intent therapy were assigned to the recurrence cohort and followed from the date of recurrence (index date). Patients without evidence of recurrence were included in the recurrence-free cohort and followed from an assigned index date based on the distribution of time between curative-intent therapy and recurrence in the recurrence cohort. Healthcare resource utilization (HRU) and costs (2024 USD) were compared between cohorts, adjusting for demographic and clinical characteristics.</p> Results <p>A total of 309 patients with recurrence and 302 patients without recurrence were included. In the recurrence and recurrence-free cohorts, respectively, mean age was 75.0 and 74.5&#xa0;years (<i>p</i> = 0.21), with male patients representing 66.3% and 60.3% (<i>p</i> = 0.12). Mean follow-up was 20.8 and 22.0&#xa0;months, respectively. Per patient per month (PPPM) mean all-cause total healthcare costs were significantly higher in the recurrence cohort compared with the recurrence-free cohort ($14,697 vs $6223; adjusted cost difference [ACD] $9205; <i>p</i> &lt; 0.01). Similarly, PPPM HCC-related total costs were $11,202 vs $3313 (ACD $10,021; <i>p</i> &lt; 0.01). Inpatient visit costs were the major driver for the higher all-cause and HCC-related total costs in the recurrence cohort versus recurrence-free cohort.</p> Conclusions <p>Findings suggest a significant HRU burden and high total healthcare costs for patients with early-stage HCC who experience disease recurrence after curative-intent therapy compared with patients who remain recurrence free. This underscores a need for future novel therapies that offer recurrence-free survival benefits and have the potential to reduce the economic burden of managing early-stage HCC.</p>

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Economic Burden of Recurrence in Early-Stage Hepatocellular Carcinoma Treated with Surgical Resection or Local Ablation in the United States: A Retrospective Analysis of Surveillance, Epidemiology and End Results–Medicare Data

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月8日

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  • Neil Mehta,
  • Liya Wang,
  • Shital Kamble,
  • Yan Song,
  • Emily Gao,
  • Abby Siegel,
  • Angie Lax,
  • Sanjana Sundaresan,
  • Adina Zhang,
  • Vicky Wei,
  • Usha Malhotra

摘要

Introduction

Patients with early-stage hepatocellular carcinoma (HCC) who undergo curative-intent therapy remain at risk of disease recurrence. This study aimed to quantify the economic burden associated with disease recurrence in these patients.

Methods

Patients ≥ 66 years old with early-stage HCC who have achieved complete radiological response via surgical resection or local ablation were selected from the SEER–Medicare database (2007–2017). Patients with evidence of recurrence following complete radiological response with curative-intent therapy were assigned to the recurrence cohort and followed from the date of recurrence (index date). Patients without evidence of recurrence were included in the recurrence-free cohort and followed from an assigned index date based on the distribution of time between curative-intent therapy and recurrence in the recurrence cohort. Healthcare resource utilization (HRU) and costs (2024 USD) were compared between cohorts, adjusting for demographic and clinical characteristics.

Results

A total of 309 patients with recurrence and 302 patients without recurrence were included. In the recurrence and recurrence-free cohorts, respectively, mean age was 75.0 and 74.5 years (p = 0.21), with male patients representing 66.3% and 60.3% (p = 0.12). Mean follow-up was 20.8 and 22.0 months, respectively. Per patient per month (PPPM) mean all-cause total healthcare costs were significantly higher in the recurrence cohort compared with the recurrence-free cohort ($14,697 vs $6223; adjusted cost difference [ACD] $9205; p < 0.01). Similarly, PPPM HCC-related total costs were $11,202 vs $3313 (ACD $10,021; p < 0.01). Inpatient visit costs were the major driver for the higher all-cause and HCC-related total costs in the recurrence cohort versus recurrence-free cohort.

Conclusions

Findings suggest a significant HRU burden and high total healthcare costs for patients with early-stage HCC who experience disease recurrence after curative-intent therapy compared with patients who remain recurrence free. This underscores a need for future novel therapies that offer recurrence-free survival benefits and have the potential to reduce the economic burden of managing early-stage HCC.