Primary Liver Cancer: An NCDB Analysis of Overall Survival and Margins After Hepatectomy

Background Intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) constitute the majority of primary liver cancers. This retrospective review aimed to determine whether site of care is a significant predictor of patient outcome after hepatectomy as measured by overall survival, haz...

Full description

Saved in:
Bibliographic Details
Published in:Annals of surgical oncology 2020-04, Vol.27 (4), p.1156-1163
Main Authors: Coon, Christopher, Berger, Nicholas, Eastwood, Dan, Tsai, Susan, Christians, Kathleen, Mogal, Harveshp, Clarke, Callisia, Gamblin, T. Clark
Format: Article
Language:English
Subjects:
Academic Medical Centers - statistics & numerical data
Aged
Carcinoma, Hepatocellular - mortality
Carcinoma, Hepatocellular - surgery
Cholangiocarcinoma
Cholangiocarcinoma - mortality
Cholangiocarcinoma - surgery
Confounding Factors, Epidemiologic
Diagnosis
Female
Hepatectomy
Hepatobiliary Tumors
Hepatocellular carcinoma
Hospitals, Community - statistics & numerical data
Humans
Liver cancer
Liver Neoplasms - mortality
Liver Neoplasms - surgery
Male
Margins of Excision
Medicine
Medicine & Public Health
Middle Aged
Oncology
Patients
Propensity Score
Retrospective Studies
Surgery
Surgical Oncology
Survival
Survival Analysis
Survival Rate
United States - epidemiology
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) constitute the majority of primary liver cancers. This retrospective review aimed to determine whether site of care is a significant predictor of patient outcome after hepatectomy as measured by overall survival, hazard ratios (HRs), and resection margin status. Methods Data regarding patients with a new diagnosis of ICC and HCC who underwent hepatectomy were analyzed from the national cancer database. The patients were divided into two cohorts: those receiving treatment at academic cancer centers (ACCs) and those receiving treatment at community cancer centers (CCCs). The study adjusted for confounding variables and selection bias using propensity score matching. Median overall survival (months), hazard ratios, and resection margin status (R0, R1/R2, unknown) were examined. Results The inclusion criteria were met by 10,463 patients. After propensity matching, 5600 patients remained, with half receiving treatment at ACCs and half at CCCs. Median overall survival from the date of diagnosis for patients undergoing hepatectomy was longer at ACCs than at CCCs (28.3 vs 24.8 months; p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-019-07843-5