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Conditional survival analysis of hepatocellular carcinoma
Author(s) -
Shah Mihir M.,
Meyer Benjamin I.,
Rhee Kevin,
NeMoyer Rachel E.,
Lin Yong,
Tzeng ChingWei D.,
Jabbour Salma K.,
Kennedy Timothy J.,
Nosher John L.,
Kooby David A.,
Maithel Shishir K.,
Carpizo Darren R.
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.26049
Subject(s) - medicine , hepatocellular carcinoma , survival analysis , overall survival , hepatectomy , relative survival , surgery , resection , carcinoma , cancer , oncology , gastroenterology , cancer registry
Background Hepatocellular carcinoma (HCC) is a leading cause of cancer‐related mortality worldwide with an approximate 5‐year survival of greater than 50% in patients after surgical resection. Survival estimates have limited utility for patients who have survived several years after initial treatment. We analyzed how conditional survival (CS) after curative‐intent surgery for HCC predicts survival estimates over time. Methods NCDB (2004‐2014) was queried for patients undergoing definitive surgical resection for HCC. Cumulative overall survival (OS) was calculated using the Kaplan‐Meier method, and CS at x years after diagnosis was calculated as CS 1 = OS ( X +5) /OS ( X ) . Results The final analysis encompassed 11 357 patients. Age, negative margin status, grade severity and radiation before surgery were statistically significant predictors of cumulative overall conditional survival ( P ≤ .0001). Overall unconditional 5‐year survival was 65.7%, but CS estimates were higher. A patient who has already survived 3 years has an additional 2‐year, or 5‐year CS, estimate of 86.96%. Conclusion Survival estimates following hepatic resection in HCC patients change according to survival time accrued since surgery. CS estimates are improved relative to unconditional OS. The impact of different variables influencing OS is likewise nonlinear over the course of time after surgery.