ARRS 2019: Percutaneous Liver Ablation Intervention vs Surgery for Hepatocellular Carcinoma
Compared to surgery, percutaneous liver ablation interventions in patients with hepatocellular carcinoma were associated with lower in-hospital mortality, length of hospital stay, and hospitalization costs, according to a study presented by Sodagari et al at the American Roentgen Ray Society (ARRS) 2019 Annual Meeting (Abstract 2786).
Methods
The study was conducted to compare use rates and outcomes of locoregional liver ablation interventions for hepatocellular carcinoma with surgical procedures.
A total of 557,071 hospitalizations in patients with hepatocellular carcinoma from 2002 to 2015 were extracted from the National Inpatient Sample database, with an estimated 13,618 liver ablation interventions and 44,629 surgical procedures performed. Hospitalizations with coexisting diagnoses of secondary hepatic and primary biliary malignancies, neuroendocrine tumors and benign hepatobiliary neoplasms, and traumatic liver injuries were excluded from the study.
Results
Over the 14-year period, unadjusted in-hospital mortality rate, length of hospital stay, and hospitalization costs were higher for surgical procedures, and after adjusting for comorbidity score, year, and patient- and hospital-specific factors, results showed liver ablation intervention was associated with 78% lower in-hospital mortality, 37% higher routine discharge to home, 67% lower length of stay, and 71% lower cost. Age greater than 50, male sex, black and Hispanic race, public insurance coverage, and nonteaching urban hospital setting were significant predictors of undergoing liver ablation intervention vs surgery, after adjusting for confounding factors.
The authors concluded, “There is a continued increase in hospitalizations for patients with hepatocellular carcinoma. Compared to surgical procedures, percutaneous liver ablative interventions in patients with hepatocellular carcinoma are associated with lower in-hospital mortality, length of stay, and hospitalization costs, even after adjusting for comorbidities, year, and patient- and hospital-specific factors.”
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