Journal of Gastroenterology

, Volume 47, Issue 10, pp 1125–1133 | Cite as

Mortality and morbidity of hepatectomy, radiofrequency ablation, and embolization for hepatocellular carcinoma: a national survey of 54,145 patients

  • Masaya Sato
  • Ryosuke Tateishi
  • Hideo Yasunaga
  • Hiromasa Horiguchi
  • Haruhiko Yoshida
  • Shinya Matsuda
  • Kazuhiko Koike
Original Article—Liver, Pancreas, and Biliary Tract

Abstract

Background

Reported mortalities and morbidities of therapeutic procedures for liver tumors vary between studies, because of different designs and small sample sizes. We investigated the mortalities and complication rates for hepatectomy, radiofrequency ablation (RFA), and trans-catheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) in a large sample, using a nationwide Japanese database (the Diagnosis Procedure Combination database).

Methods

Data from the Diagnosis Procedure Combination database were analyzed for July 1 to December 31, 2007 and the same period in 2008. We identified 54,145 patients with HCC who underwent hepatectomy (n = 5,270), RFA (n = 11,688), or TAE (n = 37,187). In-hospital mortality and morbidity were analyzed for each procedure. The relationships between mortality and factors including patient characteristics and procedural backgrounds were assessed.

Results

In-hospital mortalities associated with hepatectomy, RFA, and TAE were 2.6 % [95 % confidence interval (CI) 2.2–3.1], 0.3 % (0.2–0.4), and 1.0 % (0.9–1.1), and post-procedural complication rates were 14.5 % (13.5–15.5), 4.5 % (4.2–4.9), and 4.5 % (4.3–4.7), respectively. Increased mortality following hepatectomy was significantly associated with older age, extended lobectomy (vs. partial hepatectomy; odds ratio [OR] 3.80, p < 0.001), lower hospital volume (OR 2.74, p < 0.001), and renal comorbidity (OR 3.01, p = 0.02). Older age and cardiac comorbidity (OR 5.14, p = 0.001) were significantly associated with RFA-related mortality, and lower hospital volume was significantly associated with TAE-related mortality (OR 1.60, p < 0.001).

Conclusions

Mortalities and morbidities associated with therapeutic procedures for liver tumors were acceptably low in Japan, but were affected by patient and institutional characteristics.

Keywords

Liver tumor Hospital volume Nationwide database 

Abbreviations

RFA

Radiofrequency ablation

TAE

Trans-catheter arterial embolization

DPC

Diagnosis Procedure Combination

ICD-10

International Classification of Diseases and Related Health Problems, Tenth Revision

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Copyright information

© Springer 2012

Authors and Affiliations

  • Masaya Sato
    • 1
  • Ryosuke Tateishi
    • 1
  • Hideo Yasunaga
    • 2
  • Hiromasa Horiguchi
    • 2
  • Haruhiko Yoshida
    • 1
  • Shinya Matsuda
    • 3
  • Kazuhiko Koike
    • 1
  1. 1.Department of Gastroenterology, Graduate School of MedicineThe University of TokyoTokyoJapan
  2. 2.Department of Health Management and Policy, Graduate School of MedicineThe University of TokyoTokyoJapan
  3. 3.Department of Preventive Medicine and Community HealthUniversity of Occupational and Environmental HealthFukuokaJapan

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