Comparing Treatment Patterns of Hepatocellular Carcinoma at Academic Centers and Non-Academic Centers Within the Mountain Region
American Journal of Surgery
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Background: Our objective is to explore differences in survival and treatment approaches for hepatocellular carcinoma (HCC) between academic centers (ACs) and non-academic centers (NACs), which may contribute to disparities in the Mountain Region (MR). Methods: Using the National Cancer Database, HCC cases from 2004 to 2015 in the MR were divided into AC and NAC subgroups. Cox-proportional hazard regression and binary logistic regression were performed to analyze survival, compare treatment patterns, and examine the effect of facility type and surgical approach on margin status. Results: Treatment at ACs, compared to NACs, is associated with improved survival. At ACs, the odds of surgical or systemic treatment were higher. The odds of receiving radiation and positive margins was lower. Overall, the odds of positive margins was higher with laparoscopic compared to open or an unspecified surgical approach; this relationship persisted on subgroup analysis of NACs, but not ACs. Conclusions: Treatment of HCC at an AC in the MR increases the odds of surgery and improves survival. A laparoscopic approach increases the odds of positive margins, irrespective of center type.
Hepatocellular carcinoma; Survival; Margin status; Laparoscopic surgery; Outcome disparities; Treatment
Oncology | Public Health
Cross, C. L.,
Williams, S. J.,
St. Hill, C. R.
Comparing Treatment Patterns of Hepatocellular Carcinoma at Academic Centers and Non-Academic Centers Within the Mountain Region.
American Journal of Surgery, 218(6),