NCDB Cooper.

Top Line: Data purports patients with stage I/II hepatocellular (HCC) have inferior survival at 5 years if treated with stereotactic body radiation (SBRT) alone versus radiofrequency ablation (RFA) alone.
The Study: Did everyone forget how annoying SEER analyses became a few years back? Apparently so because here’s yet another NCDB analysis. This one compares survival outcomes in patients with HCC treated with RFA and SBRT. Lesson one on reading the fine print of NCDB analyses: of over 47,000 eligible patients with stage I-II HCC, 3980 (or, roughly one order of magnitude less) received either RFA or SBRT. Among these, 92.6% received RFA and 296 people (or, 0.6% of the eligible population) received SBRT. Second, the NCDB doesn’t include much clinical information relevant to its endpoint, survival, including measures of liver function. However, the authors propensity matched the two cohorts and produced results showing a significantly higher survival rate at 5 years in the group that got RFA (30%) compared to the group treated with SBRT (19%).
Bottom Line: The current flood of NCDB analyses scoring big-name pubs with provocative findings may be disguising some real needs for high-quality clinical trial data.


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