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Surgeon Volume is Predictive of 5-Year Survival in Patients with Hepatocellular Carcinoma after Resection: A Population-Based Study

  • Original Article
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Journal of Gastrointestinal Surgery

Abstract

Background and Aim

No study has examined associations between physician volume or hospital volume and survival in patients with liver malignancies in the hepatitis B virus-endemic areas such as Taiwan. This study was to examine the effect of hospital and surgeon volume on 5-year survival and to determine whether hospital or surgeon volume is the stronger predictor in patients with hepatocellular carcinoma after hepatic resection in Taiwan.

Methods

Using the 1997–1999 Taiwan National Health Insurance Research Database and the 1997–2004 Cause of Death Data File, we identified 2,799 patients who underwent hepatic resection and 1,836 deaths during the 5-year follow-up period. The Cox proportional hazard regressions were performed to adjust for patient demographics, comorbidity, physician, and hospital characteristics when assessing the association of hospital and surgeon volume with 5-year survival.

Results

When we examined the effect of physician and hospital volumes separately, both physician and hospital volumes significantly predicted 5-year survival after adjusting for characteristics of patient, surgeon, and hospital. However, after we adjusted for characteristics of physician and hospital, only physician volume remained a significant predictor of the 5-year survival.

Conclusions

Physician volume is a stronger predictor of 5-year survival in hepatocellular carcinoma patients receiving hepatic resection.

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Authors and Affiliations

  1. School of Health Care Administration, Taipei Medical University, Taipei, Taiwan

    Herng-Ching Lin

  2. School of Nursing, Taipei Medical University, Taipei Medical University-Wan Fang Hospital, 250 Wu-Hsing Street, Taipei, 110, Taiwan

    Chia-Chin Lin

Authors
  1. Herng-Ching Lin
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  2. Chia-Chin Lin
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Correspondence to Chia-Chin Lin.

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Lin, HC., Lin, CC. Surgeon Volume is Predictive of 5-Year Survival in Patients with Hepatocellular Carcinoma after Resection: A Population-Based Study. J Gastrointest Surg 13, 2284–2291 (2009). https://doi.org/10.1007/s11605-009-0990-8

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  • DOI: https://doi.org/10.1007/s11605-009-0990-8

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