Faculty Collaboration Database

Palliative interventions for hepatocellular carcinoma patients: analysis of the National Cancer Database. Ann Palliat Med 2017 Jan;6(1):26-35

Date

01/08/2017

Pubmed ID

28061532

DOI

10.21037/apm.2016.11.02

Scopus ID

2-s2.0-85010755580 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

BACKGROUND: Palliative therapies are provided to a subset of hepatocellular carcinoma (HCC) patients with the aim of providing symptomatic relief, better quality of life and improved survival. The present study sought to assess and compare the efficacy of different palliative therapies for HCC.

METHODS: The National Cancer Database (NCDB), a retrospective national database that captures approximately 70% of all patients treated for cancer in the US, was queried for patients with HCC who were deemed unresectable from 1998-2011. Patients were stratified by receipt of palliative therapy. Survival analysis was examined by log-rank test and Kaplan Meier curves, and a multivariate proportional hazards model was utilized to identify the predictors of survival.

RESULTS: A total of 3,267 patients were identified; 287 (8.7%) received surgical palliation, 827 (25.3%) received radiotherapy (RT), 877 (26.8%) received chemotherapy, 1,067 (32.6%) received pain management therapy, while 209 (6.4%) received a combination of the previous three modalities. On multivariate analysis palliative RT was identified as a positive predictor of survival [hazards ratio (HR) 0.65; 95% CI, 0.50-0.83]. Stratifying by disease stage, palliative RT provided a significant survival benefit for patients with stage IV disease.

CONCLUSIONS: Palliative RT appears to extend survival and should be considered for patients presenting with late stage HCC.

Author List

Hammad AY, Robbins JR, Turaga KK, Christians KK, Gamblin TC, Johnston FM

Authors

Kathleen K. Christians MD Professor in the Surgery department at Medical College of Wisconsin
Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Age Factors
Aged
Antineoplastic Agents
Carcinoma, Hepatocellular
Databases, Factual
Digestive System Surgical Procedures
Female
Humans
Kaplan-Meier Estimate
Liver
Liver Neoplasms
Male
Middle Aged
Multivariate Analysis
Neoplasm Staging
Pain Management
Palliative Care
Proportional Hazards Models
Radiotherapy
Retrospective Studies
Survival Rate
Tumor Burden
alpha-Fetoproteins