Conditional survival analysis of hepatocellular carcinoma

Mihir M. Shah; Benjamin I. Meyer; Kevin Rhee; Rachel E. NeMoyer; Yong Lin; Ching Wei D. Tzeng; Salma K. Jabbour; Timothy J. Kennedy; John L. Nosher; David A. Kooby; Shishir K. Maithel; Darren R. Carpizo

doi:10.1002/jso.26049

Conditional survival analysis of hepatocellular carcinoma

Mihir M. Shah, Benjamin I. Meyer, Kevin Rhee, Rachel E. NeMoyer, Yong Lin, Ching Wei D. Tzeng, Salma K. Jabbour, Timothy J. Kennedy, John L. Nosher, David A. Kooby, Shishir K. Maithel, Darren R. Carpizo

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

Abstract

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 CS₁ = 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.

Original language	English (US)
Pages (from-to)	684-690
Number of pages	7
Journal	Journal of Surgical Oncology
Volume	122
Issue number	4
DOIs	https://doi.org/10.1002/jso.26049
State	Published - Sep 1 2020

All Science Journal Classification (ASJC) codes

Surgery
Oncology

Keywords

cirrhosis
conditional survival
hepatocellular carcinoma
liver cancer
liver surgery

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10.1002/jso.26049

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@article{9009337685bc49cfbe4c3f98a4120401,

title = "Conditional survival analysis of hepatocellular carcinoma",

abstract = "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 CS1 = 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.",

keywords = "cirrhosis, conditional survival, hepatocellular carcinoma, liver cancer, liver surgery",

author = "Shah, {Mihir M.} and Meyer, {Benjamin I.} and Kevin Rhee and NeMoyer, {Rachel E.} and Yong Lin and Tzeng, {Ching Wei D.} and Jabbour, {Salma K.} and Kennedy, {Timothy J.} and Nosher, {John L.} and Kooby, {David A.} and Maithel, {Shishir K.} and Carpizo, {Darren R.}",

note = "Funding Information: Research reported in this publication was supported in part by the NIH under award number R01 CA20080. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The data used in the study are derived from a deidentified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator. DRC is funded by the following grant: NIH R01 CA20080. Funding Information: Research reported in this publication was supported in part by the NIH under award number R01 CA20080. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The data used in the study are derived from a deidentified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator. DRC is funded by the following grant: NIH R01 CA20080. Publisher Copyright: {\textcopyright} 2020 Wiley Periodicals LLC",

year = "2020",

month = sep,

day = "1",

doi = "10.1002/jso.26049",

language = "English (US)",

volume = "122",

pages = "684--690",

journal = "Journal of Surgical Oncology",

issn = "0022-4790",

publisher = "Wiley-Liss Inc.",

number = "4",

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TY - JOUR

T1 - Conditional survival analysis of hepatocellular carcinoma

AU - Shah, Mihir M.

AU - Meyer, Benjamin I.

AU - Rhee, Kevin

AU - NeMoyer, Rachel E.

AU - Lin, Yong

AU - Tzeng, Ching Wei D.

AU - Jabbour, Salma K.

AU - Kennedy, Timothy J.

AU - Nosher, John L.

AU - Kooby, David A.

AU - Maithel, Shishir K.

AU - Carpizo, Darren R.

N1 - Funding Information: Research reported in this publication was supported in part by the NIH under award number R01 CA20080. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The data used in the study are derived from a deidentified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator. DRC is funded by the following grant: NIH R01 CA20080. Funding Information: Research reported in this publication was supported in part by the NIH under award number R01 CA20080. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The data used in the study are derived from a deidentified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator. DRC is funded by the following grant: NIH R01 CA20080. Publisher Copyright: © 2020 Wiley Periodicals LLC

PY - 2020/9/1

Y1 - 2020/9/1

N2 - 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 CS1 = 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.

AB - 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 CS1 = 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.

KW - cirrhosis

KW - conditional survival

KW - hepatocellular carcinoma

KW - liver cancer

KW - liver surgery

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U2 - 10.1002/jso.26049

DO - 10.1002/jso.26049

M3 - Article

C2 - 32524634

AN - SCOPUS:85086269180

SN - 0022-4790

VL - 122

SP - 684

EP - 690

JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

IS - 4

ER -

Conditional survival analysis of hepatocellular carcinoma

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All Science Journal Classification (ASJC) codes

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