Nima Kokabi1, Richard Duszak2, Minzhi Xing3, David H Howard4, Kimberly E Applegate5, Juan C Camacho6, Hyun S Kim1,7. 1. Division of Interventional Radiology, Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, CT, 06519, USA. 2. Department of Radiology & Imaging Sciences, Emory University School of Medicine, Atlanta, GA, 30322, USA. 3. School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA. 4. Department of Health Policy & Management, Rollins School of Public Health, Emory University School of Medicine, Atlanta, GA, 30322, USA. 5. Department of Radiology, University of Kentucky College of Medicine, Lexington, KY, 40536, USA. 6. Department of Radiology, Medical University of South Carolina, Charleston, SC, 29425, USA. 7. Yale Cancer Center, Yale University, New Haven, CT, 06519, USA.
Abstract
AIM: To investigate determinants of receiving cancer-directed therapies and their potential survival impact in nonresected hepatocellular carcinoma (HCC) Materials & methods: Nonsurgically resected HCC patients between 2000 and 2010 were stratified by American Joint Committee on Cancer staging and the type of therapy. Predictors of receiving therapy were identified and implication on survival was evaluated. RESULTS: Out of 9239 patients included, those receiving any therapy demonstrated prolonged overall survival with following median overall survival (months): ablation (30.8), Yttrium-90 (15.6), transcatheter arterial chemoembolization (15.5), Sorafenib (5.6), versus no cancer-directed therapy (3.7; p-values <0.001). Overall, 36% of patients received cancer-directed therapy including 47% with stage I/II. Favorable sociodemographic factors predicted receipt of percutaneous locoregional therapies (p-values <0.05). DISCUSSION & CONCLUSION: There appears to be significant disparity in care of nonresected HCC patients with significant underutilization of cancer-directed therapies.
AIM: To investigate determinants of receiving cancer-directed therapies and their potential survival impact in nonresected hepatocellular carcinoma (HCC) Materials & methods: Nonsurgically resected HCC patients between 2000 and 2010 were stratified by American Joint Committee on Cancer staging and the type of therapy. Predictors of receiving therapy were identified and implication on survival was evaluated. RESULTS: Out of 9239 patients included, those receiving any therapy demonstrated prolonged overall survival with following median overall survival (months): ablation (30.8), Yttrium-90 (15.6), transcatheter arterial chemoembolization (15.5), Sorafenib (5.6), versus no cancer-directed therapy (3.7; p-values <0.001). Overall, 36% of patients received cancer-directed therapy including 47% with stage I/II. Favorable sociodemographic factors predicted receipt of percutaneous locoregional therapies (p-values <0.05). DISCUSSION & CONCLUSION: There appears to be significant disparity in care of nonresected HCC patients with significant underutilization of cancer-directed therapies.