Understanding the Outcomes of Patients with Hepatocellular Carcinoma
Research type
Research Study
Full title
Understanding the outcomes of patients with cirrhosis and hepatocellular carcinoma (HCC) in England
IRAS ID
225039
Contact name
Ian Rowe
Contact email
Sponsor organisation
University of Leeds
Duration of Study in the UK
1 years, 6 months, 1 days
Research summary
Liver disease is increasing and is a leading cause of death in people of working age. As liver disease progresses, it leads to cirrhosis and this can cause liver failure as well as increasing the risk of liver cancer (hepatocellular carcinoma, HCC). The treatment of HCC in the setting of cirrhosis is complex and depends not only on how advanced the cancer is, but also the severity of the underlying cirrhosis since this will influence the type of treatment possible.
This project aims to employ routine health data to understand the factors that influence survival in patients with HCC including cancer stage at presentation, stage and aetiology of underlying liver disease, age, co-morbidity, and cancer-specific treatments at a population level. It also aims to assess any regional variations in treatment allocation and clinical outcomes. In addition to overall survival, the rate of progression of underlying liver disease will also be investigated, to understand the competing mortality of HCC and cirrhosis.
It will use existing population health datasets to address these questions, including the National Cancer Registration and Analysis Service (NCRAS) dataset to identify patients with HCC. This is linked to the Hospital Episode Statistics (HES) database, which will be used to identify HCC treatments and patients’ baseline characteristics. The HES database will also be used to determine the severity of liver disease by analysing specific diagnoses and procedures related to complications of cirrhosis, such as ascites (the collection of abdominal fluid) and varices (enlarged veins in the gullet which can cause bleeding in the gut).
This project has the potential to provide information of relevance to both improve and reduce variation in outcomes for patients with liver disease and to shape future research in early diagnosis and treatment of HCC in the setting of cirrhosis.
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
18/NW/0206
Date of REC Opinion
17 Apr 2018
REC opinion
Further Information Favourable Opinion