TY - JOUR
T1 - Survival in relation to hospital type after resection or sorafenib treatment for hepatocellular carcinoma in The Netherlands
AU - van der Geest, Lydia G. M.
AU - van Meer, Suzanne
AU - Schrier, Janina G. H.
AU - Ijzermans, Jan N. M.
AU - Klümpen, Heinz-Josef
AU - van Erpecum, Karel J.
AU - de Man, Rob A.
PY - 2015
Y1 - 2015
N2 - Background and objective: Despite an increase in recent years, hepatocellular carcinoma remains uncommon in the Netherlands. The aim of the current study is to explore potential effects of hospital type and volume on outcomes after resection or sorafenib in patients with hepatocellular carcinoma. Methods: Initial treatment and survival of patients with hepatocellular carcinoma diagnosed in the period 2005-2011 were based on data of the Netherlands Cancer Registration. Potential risk factors (including hospital type and volume) for 30-days postoperative and long-term mortality in patients who underwent resection and in patients treated with sorafenib were evaluated by uni- and multivariate analyses. Results: In the period 2005-2011, 2402 patients were diagnosed with hepatocellular carcinoma: 12% received resection and 9% sorafenib. Postoperative mortality was higher in non-university hospitals (13% versus 4%; P= 0.01). Resection in non-university hospitals was associated with higher postoperative mortality (odds ratio 3.38, 95% confidence interval 1.37-10.68) and long-term mortality (hazard ratio 1.21, 95% confidence interval 1.04-1.40). Sorafenib treatment in non-university hospitals was also associated with higher long-term mortality (hazard ratio 1.39, 95% confidence interval 1.06-1.82). Hospital volume was not independent predictor for outcome. Conclusion: In low incidence countries, outcome after resection or sorafenib for hepatocellular carcinoma may differ between various hospital types.
AB - Background and objective: Despite an increase in recent years, hepatocellular carcinoma remains uncommon in the Netherlands. The aim of the current study is to explore potential effects of hospital type and volume on outcomes after resection or sorafenib in patients with hepatocellular carcinoma. Methods: Initial treatment and survival of patients with hepatocellular carcinoma diagnosed in the period 2005-2011 were based on data of the Netherlands Cancer Registration. Potential risk factors (including hospital type and volume) for 30-days postoperative and long-term mortality in patients who underwent resection and in patients treated with sorafenib were evaluated by uni- and multivariate analyses. Results: In the period 2005-2011, 2402 patients were diagnosed with hepatocellular carcinoma: 12% received resection and 9% sorafenib. Postoperative mortality was higher in non-university hospitals (13% versus 4%; P= 0.01). Resection in non-university hospitals was associated with higher postoperative mortality (odds ratio 3.38, 95% confidence interval 1.37-10.68) and long-term mortality (hazard ratio 1.21, 95% confidence interval 1.04-1.40). Sorafenib treatment in non-university hospitals was also associated with higher long-term mortality (hazard ratio 1.39, 95% confidence interval 1.06-1.82). Hospital volume was not independent predictor for outcome. Conclusion: In low incidence countries, outcome after resection or sorafenib for hepatocellular carcinoma may differ between various hospital types.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84949313543&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/25846519
U2 - https://doi.org/10.1016/j.clinre.2015.02.004
DO - https://doi.org/10.1016/j.clinre.2015.02.004
M3 - Article
C2 - 25846519
SN - 2210-7401
VL - 39
SP - 725
EP - 735
JO - Clinics and research in hepatology and gastroenterology
JF - Clinics and research in hepatology and gastroenterology
IS - 6
ER -