Hospital volume of percutaneous radiofrequency ablation is closely associated with treatment outcomes for patients with hepatocellular carcinoma

Authors

  • Li-Chun Lu MD,

    1. Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan
    2. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
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    • The first 2 authors contributed equally to this article.

  • Yu-Yun Shao MD,

    1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
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    • The first 2 authors contributed equally to this article.

  • Raymond N. C. Kuo PhD,

    1. Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan
    2. Taiwan Cancer Registry, Taipei, Taiwan
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  • Zhong-Zhe Lin MD, PhD,

    1. Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan
    2. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
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  • Yi-Chun Yeh MS,

    1. Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan
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  • Wen-Yi Shau MD, PhD,

    1. Division of Health Technology Assessment, Center For Drug Evaluation, Taipei, Taiwan
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  • Chih-Hung Hsu MD, PhD,

    1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Ann-Lii Cheng MD, PhD,

    Corresponding author
    1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
    2. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
    3. Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Ann-Lii Cheng, Department of Oncology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 10002, Taiwan

      Mei-Shu Lai, Institute of Preventive Medicine, College of Public Health, National Taiwan University, Room 518, No. 17, Xuzhou Road, Taipei 10055, Taiwan

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    • Fax: (011) 886 2 23711174

  • Mei-Shu Lai MD, PhD

    Corresponding author
    1. Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan
    2. Taiwan Cancer Registry, Taipei, Taiwan
    3. Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
    • Ann-Lii Cheng, Department of Oncology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 10002, Taiwan

      Mei-Shu Lai, Institute of Preventive Medicine, College of Public Health, National Taiwan University, Room 518, No. 17, Xuzhou Road, Taipei 10055, Taiwan

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    • Fax: (011) 886 2 2351173


Abstract

BACKGROUND:

Hospital volume for several major operations is associated with treatment outcomes. In this study, the authors explored the influence of hospital radiofrequency ablation (RFA) volume on the prognosis of patients who received RFA for hepatocellular carcinoma (HCC).

METHODS:

The authors searched for all patients who were diagnosed with stage I or stage II HCC from 2004 to 2006 and who received RFA as first-line therapy in a population-based cohort. Overall survival (OS) and liver cancer-specific survival (CSS) were compared according to hospital volume. A Cox proportional hazards model was used for multivariate analysis.

RESULTS:

In total, 661 patients received first-line RFA for stage I and II HCC in 28 hospitals. Among these, there were 480 patients (72.6%) in the high-volume group (those who received RFA at hospitals that treated >10 first-line patients per year), and there were 181 patients (27.4%) in the low-volume group (those who received RFA at hospitals that treated ≤10 first-line patients per year). The sex, age, stage, tumor size, and year of diagnosis for patients in the 2 groups did not differ significantly. Patients in the high-volume group demonstrated significantly longer OS and CSS than those in the low-volume group (5-year OS rate, 58.7% vs 47.2%; P = .001; 5-year CSS rate, 67.1% vs 57.1%; P = .009). After adjusting for covariates, high-volume hospitals remained an independent predictor of longer OS (hazard ratio, 0.57; P < .001) and CSS (hazard ratio, 0.57; P = .003).

CONCLUSIONS:

Patients who received first-line RFA for HCC in high-volume hospitals demonstrated better survival outcomes. Cancer 2013. © 2012 American Cancer Society.

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