Little is known about provider and health system factors that affect receipt of active therapy and outcomes of patients with hepatocellular carcinoma.
Dr David Kaplan and colleagues from Pennsylvania, USA investigated patient, provider, and health system factors associated with receipt of active hepatocellular carcinoma therapy and overall survival.
The researchers performed a national, retrospective cohort study of all patients diagnosed with HCC from 2008 through 2010, and followed through 2014 who received care through the Veterans Administration.
|Transarterial therapy was associated with reduced mortality|
Outcomes were receipt of active hepatocellular carcinoma therapy, and overall survival.
The team found that receiving care at an academically affiliated Veterans Administration hospital or a multi-specialist evaluation, but not review by a multidisciplinary tumor board, was associated with a higher likelihood of receiving active hepatocellular carcinoma therapy.
The research team noted that liver transplantation, liver resection, ablative therapy, and transarterial therapy were associated with reduced mortality.
Subspecialist care by hepatologists, medical oncologists, or surgeons within 30 days of hepatocellular carcinoma diagnosis, and review by a multidisciplinary tumor board, were associated with reduced mortality.
Dr Kaplan's team concludes, "In a retrospective cohort study of almost 4000 patients with hepatocellular carcinoma cared for at VA centers, geographic, provider, and system differences in receipt of active hepatocellular carcinoma therapy are associated with patient survival."
"Multidisciplinary methods of care delivery for hepatocellular carcinoma should be prospectively evaluated and standardized to improve access to hepatocellular carcinoma therapy, and optimize outcomes."