Surgical Therapy for Early Hepatocellular Carcinoma in the Modern Era

• DOI: 10.1097/sla.0b013e31827da749
• Publication Date: 2013-01-09T02:07:43Z
• Authors: Hari Nathan; Omar Hyder; Skye C. Mayo; Kenzo Hirose; Christopher L. Wo...; Michael A. Choti; Timothy M. Pawlik
• Keywords: Aged, 80 and over; Male; Carcinoma, Hepatocellular; Time Factors; Liver Neoplasms; Medicare; United States; 3. Good health; Cohort Studies; 03 medical and health sciences; 0302 clinical medicine; Hepatectomy; Humans; Female; Aged; Retrospective Studies; SEER Program

We sought to quantify the use of and analyze factors predictive receipt surgical therapy for early hepatocellular carcinoma (HCC).The incidence HCC is increasing, options have expanded, but has not been examined in a modern cohort.A retrospective cohort study was performed using data from 1998-2007 Surveillance, Epidemiology, End Results-Medicare linked database. Data were analyzed patients 66 years age older with (tumors ≤5 cm without metastatic disease, nodal metastasis, extrahepatic extension, or major vascular invasion). Both Results Medicare used ascertain as well comorbidity burden other patient hospital variables. Multivariable logistic regression models associated therapy.Our selection criteria identified 1745 this study. Most had tumors between 2 5 size (n = 1440, 83%). Solitary 1121, 64%) more common than multiple 624, 36%). A total 820 (47%) received no therapy. Among 741 solitary, unilobar microscopic confirmation HCC, 246 (33%) Of 535 liver-related comorbidities, 273 (51%) did receive In multivariable analysis, age, income, tumor factors, therapy.Although some may be candidates therapy, these suggest that there significant missed opportunity improve survival through