Impact of cancer center accreditation on outcomes of patients undergoing resection for hepatocellular carcinoma: A SEER-Medicare analysis.

Journal Article (Journal Article)


We sought to assess variations in outcomes among patients undergoing resection for hepatocellular carcinoma (HCC) at centers with varied accreditation status.


Patients undergoing resection for HCC from 2004 to 2016 were identified from the linked SEER-Medicare database. Short- and long-term outcomes as well as expenditures associated with receipt of surgery were examined based on cancer center accreditation.


Among 1390 patients, 46.1% (n = 641) were treated at unaccredited centers, 39.3% (n = 546) at CoC-accredited and 14.6% (n = 203) at NCI-designated centers. Patients undergoing resection of HCC at NCI-designated hospitals had lower odds of complications (OR = 0.66, 95%CI: 0.45-0.98) and 90-day mortality (OR = 0.31, 95%CI: 0.11-0.85) after major liver resection compared with individuals treated at CoC-accredited centers. Receipt of surgery at NCI-designated hospitals (ref: CoC-accredited; HR = 0.81, 95%CI: 0.66-0.99) was an independent predictor of improved survival. Medicare payments for liver resection were comparable at different accreditation status centers (NCI: $21,760 vs CoC: $24,059 vs unaccredited: $24,724, p = 0.18).


Patients undergoing resection of HCC at NCI-designated hospitals had improved outcomes for the same level of Medicare expenditure compared with patients treated at CoC-accredited centers.

Full Text

Duke Authors

Cited Authors

  • Tsilimigras, DI; Hyer, JM; Diaz, A; Moris, D; Abbas, A; Dillhoff, M; Cloyd, JM; Ejaz, A; Beane, JD; Tsung, A; Pawlik, TM

Published Date

  • September 2021

Published In

Volume / Issue

  • 222 / 3

Start / End Page

  • 570 - 576

PubMed ID

  • 33485619

Electronic International Standard Serial Number (EISSN)

  • 1879-1883

International Standard Serial Number (ISSN)

  • 0002-9610

Digital Object Identifier (DOI)

  • 10.1016/j.amjsurg.2021.01.015


  • eng