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02-02-2023 | Hepatocellular Carcinoma | Original Article

Hospital Volume and Textbook Outcomes in Minimally Invasive Hepatectomy for Hepatocellular Carcinoma

Authors: Yutaka Endo, Zorays Moazzam, Selamawit Woldesenbet, Henrique A Lima, Laura Alaimo, Muhammad Musaab Munir, Chanza F. Shaikh, Jason Yang, Lovette Azap, Erryk Katayama, Minoru Kitago, Timothy M. Pawlik

Published in: Journal of Gastrointestinal Surgery | Issue 5/2023

Abstract

Background

Hospital volume affects outcomes of patients who underwent resection for hepatocellular carcinoma (HCC). We sought to assess the impact of minimally invasive hepatectomy (MIH) volume on short- and long-term outcomes among patients with HCC.

Methods

Patients who underwent MIH for HCC from 2010 to 2018 were identified from the National Cancer Database. Multivariable modeling with restricted cubic splines (RCS) was utilized to identify the MIH hospital volume threshold. Textbook outcome (TO) was defined as no conversion to open resection, negative margins after resection (R0), no extended length-of-stay, no readmission, and no 90-day mortality.

Results

Among 3268 patients who underwent MIH for HCC, median age was 65.0 (IQR 59.0–72.0) and the majority was male (n = 2308, 70.6%). MIH hospital volume ranged from 1 to 87 cases, with a median of 13 (IQR 7–23). Overall, 2151 (60.9%) patients achieved TO after resection. While particularly high rates of achievement were found for no 90-day mortality (n = 3106, 95.0%), no readmission (n = 3153, 96.5%), and R0 resection (n = 3,017, 92.3%), other TO components including no conversion to open (n = 2778, 85.0%) and no prolonged LOS (n = 2584, 79.1%) were achieved less frequently. Patients treated at high-volume centers (≥50 MIH cases) were more likely to experience TO (high volume centers, n = 334, 68.7% vs. low volume centers, n = 1656, 59.5%, p < 0.001) and better long-term survival (5-year OS; high volume centers, 64.7% vs. low volume centers, 54.6%, p < 0.001).

Conclusions

MIH hospital volume was associated with a higher likelihood of achieving TO and improved long-term survival among patients undergoing resection of HCC.

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Title: Hospital Volume and Textbook Outcomes in Minimally Invasive Hepatectomy for Hepatocellular Carcinoma
Authors: Yutaka Endo
Zorays Moazzam
Selamawit Woldesenbet
Henrique A Lima
Laura Alaimo
Muhammad Musaab Munir
Chanza F. Shaikh
Jason Yang
Lovette Azap
Erryk Katayama
Minoru Kitago
Timothy M. Pawlik
Publication date: 02-02-2023
Publisher: Springer US
Keywords: Hepatocellular Carcinoma
Hepatocellular Carcinoma
Minimally Invasive Surgery
Published in: Journal of Gastrointestinal Surgery / Issue 5/2023
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-023-05609-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hospital Volume and Textbook Outcomes in Minimally Invasive Hepatectomy for Hepatocellular Carcinoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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