Surgical Demand and Migratory Patterns: A 10-Year Forecast for Hepatectomy in Oncology in the Northern Region of Brazil

PURPOSE This article aims to forecast the 10-year demand for hepatectomy among liver cancer patients in Northern Brazil and assess the potential need for inter-regional collaboration based on migration patterns. METHODS An observational study following the STROBE checklist. Annual estimates of surgical procedures carried out by region were obtained from data from the Department of Informatics of the Unified Health System of Brazil (DataSus). Patient's identities are preserved, and the conduction of any research with data from DATASUS is ethically approved. All hepatectomy procedures in oncology (Code: 0416040101) were considered based on the PICO principle: People with liver cancer in Brazil from November 2013 to November 2023 (Population);hepatectomy in oncology and total costs for the surgical procedure according to the patient's place of residence and according to the patient's place of hospitalization (Interest);Brazilian North Region (Context). Forecasting models using historical surgical volume data to predict annual oncology hepatectomy surgeries for the next ten years (2024 - 2033). Total expenditure figures by patient place of residence and by place of hospitalization were also calculated using ARIMA (R programming 4.0). RESULTS The ARIMA forecast predicts an average annual demand of 45 (95% CI: 21.37-68.63) hepatectomy procedures for oncology patients residing in the northern region. Conversely, the forecast for in-region hospitalizations is 40 (95% CI: 17.19-62.81) patients per year. By 2033, an estimated 3.2 (95% CI: -0.35-6.75) patients from the Northern Region are expected to migrate annually to other Brazilian regions for hepatectomy procedures. The total estimated expenditure in 2033 for patients in the northern region is R$194,680.1 (95% CI: R$110,723.103 - R$278,637.1). However, the estimate of expenses for hospitalizations in the north region based on data from the following 10-years (2024 to 2033) indicates a value of R$166,798 (95% CI: R$86,991.96 - R$246,605.0), indicating that there may be a trend toward underfunding for inpatients in the northern region over the next 10-years. CONCLUSION Migratory trends in liver neoplasm surgery might endure in northern Brazil for the next decade. To ensure safe, affordable, and timely cancer surgery nationwide, inter-regional collaboration is essential for delivering impactful liver neoplasm surgical treatment.