2018
Transarterial Chemoembolization within First 3 Months of Sorafenib Initiation Improves Overall Survival in Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study with Propensity Matching
Kaplan DE, Mehta R, D'Addeo K, Gade TP, Taddei TH. Transarterial Chemoembolization within First 3 Months of Sorafenib Initiation Improves Overall Survival in Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study with Propensity Matching. Journal Of Vascular And Interventional Radiology 2018, 29: 540-549.e4. PMID: 29477619, PMCID: PMC6104514, DOI: 10.1016/j.jvir.2017.11.033.Peer-Reviewed Original ResearchConceptsUnresectable hepatocellular carcinomaTransarterial chemoembolizationHepatocellular carcinomaMacrovascular invasionPropensity matchingOverall survivalEnd-stage liver disease (MELD) scoreBarcelona Clinic Liver Cancer stageVeterans Health Administration hospitalsInitiation of sorafenibSignificant hepatic dysfunctionLiver Disease scoreRetrospective cohort studyAdjuvant transarterial chemoembolizationLiver Cancer stageMulti-institutional studySorafenib initiationHepatic dysfunctionCohort studyMost patientsSystemic therapyPrimary outcomeUnadjusted analysesMultimodal therapySubgroup analysisSorafenib prescribed by gastroenterologists and hepatologists for hepatocellular carcinoma
Kaplan DE, Mehta R, D’Addeo K, Valderrama A, Taddei TH. Sorafenib prescribed by gastroenterologists and hepatologists for hepatocellular carcinoma. Medicine 2018, 97: e9757. PMID: 29369224, PMCID: PMC5794408, DOI: 10.1097/md.0000000000009757.Peer-Reviewed Original ResearchConceptsAdvanced hepatocellular carcinomaHepatocellular carcinomaOverall survivalBarcelona Clinic Liver Cancer (BCLC) systemManagement of HCCVeterans Health Administration hospitalsRetrospective cohort studyFirst-line therapySimilar survival outcomesChild-TurcottePugh scoreComorbidity indexChart abstractionCohort studySurvival benefitSystemic therapyBCLC stagePrimary outcomePrescriber typeSurvival outcomesAdministration HospitalMultivariable modelProvider specialtyCancer stagingHCC diagnosis
2017
Starting Dose of Sorafenib for the Treatment of Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study
Reiss KA, Yu S, Mamtani R, Mehta R, D'Addeo K, Wileyto EP, Taddei TH, Kaplan DE. Starting Dose of Sorafenib for the Treatment of Hepatocellular Carcinoma: A Retrospective, Multi-Institutional Study. Journal Of Clinical Oncology 2017, 35: jco.2017.73.824. PMID: 28872925, PMCID: PMC5662845, DOI: 10.1200/jco.2017.73.8245.Peer-Reviewed Original ResearchConceptsSorafenib patientsHazard ratioOverall survivalHepatocellular carcinomaPotential confoundersNoninferiority marginEnd-stage liver disease-sodium (MELD-Na) scoreVeterans Health Administration hospitalsHigher Child-TurcottePotential treatment biasReduced pill burdenComorbidity Index scorePrimary end pointFirst-line therapyGastrointestinal adverse effectsDose of sorafenibSignificant OS differenceAdvanced hepatocellular carcinomaLower overall survivalMultivariate logistic regressionMulti-institutional studyChild-TurcotteOS relativePugh scorePurpose SorafenibHealthcare Costs Related to Treatment of Hepatocellular Carcinoma Among Veterans With Cirrhosis in the United States
Kaplan DE, Chapko MK, Mehta R, Dai F, Skanderson M, Aytaman A, Baytarian M, D’Addeo K, Fox R, Hunt K, Pocha C, Valderrama A, Taddei TH, Group V. Healthcare Costs Related to Treatment of Hepatocellular Carcinoma Among Veterans With Cirrhosis in the United States. Clinical Gastroenterology And Hepatology 2017, 16: 106-114.e5. PMID: 28756056, PMCID: PMC5735018, DOI: 10.1016/j.cgh.2017.07.024.Peer-Reviewed Original ResearchConceptsMultivariable generalized linear modelsMultidisciplinary tumor boardHepatocellular carcinomaIntegrated health systemCancer-related costsHealthcare costsLiver transplantationBCLC stageLiver diseaseTumor boardBarcelona Clinic Liver Cancer stageVeterans Affairs Corporate Data WarehouseHealth systemCases of HCCBasis of receiptLiver disease cohortReceipt of transplantationLiver disease etiologyChronic liver diseaseLiver Cancer stageLiver cancer surveillanceBasis of severityHospital academic affiliationCorporate Data WarehouseCirrhosis controlsRacial and Ethnic Disparities in Oncotype DX Test Receipt in a Statewide Population-Based Study.
Davis BA, Aminawung JA, Abu-Khalaf MM, Evans SB, Su K, Mehta R, Wang SY, Gross CP. Racial and Ethnic Disparities in Oncotype DX Test Receipt in a Statewide Population-Based Study. Journal Of The National Comprehensive Cancer Network 2017, 15: 346-354. PMID: 28275035, DOI: 10.6004/jnccn.2017.0034.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAged, 80 and overBiomarkers, TumorBreast NeoplasmsConnecticutFemaleGene Expression ProfilingGenetic TestingHealth Services AccessibilityHealthcare DisparitiesHumansLymphatic MetastasisMiddle AgedNeoplasm GradingNeoplasm StagingOdds RatioPatient Outcome AssessmentPopulation SurveillanceRegistriesRetrospective StudiesSocioeconomic FactorsYoung AdultConceptsPopulation-based studyOncotype DXODX testingBreast cancerHispanic womenHormone receptor-positive breast cancerReceptor-positive breast cancerRetrospective population-based studyWhite womenRacial disparitiesGEP test resultsBreast cancer careBreast cancer outcomesStudy inclusion criteriaGene expression profiling testsMore white womenClinical characteristicsTest receiptCancer outcomesCancer careInclusion criteriaLogistic analysisEthnic disparitiesStatewide populationWomenAssociation of Provider Specialty and Multidisciplinary Care With Hepatocellular Carcinoma Treatment and Mortality
Serper M, Taddei TH, Mehta R, D’Addeo K, Dai F, Aytaman A, Baytarian M, Fox R, Hunt K, Goldberg DS, Valderrama A, Kaplan DE, Group V. Association of Provider Specialty and Multidisciplinary Care With Hepatocellular Carcinoma Treatment and Mortality. Gastroenterology 2017, 152: 1954-1964. PMID: 28283421, PMCID: PMC5664153, DOI: 10.1053/j.gastro.2017.02.040.Peer-Reviewed Original ResearchMeSH KeywordsAgedCarcinoma, HepatocellularChi-Square DistributionDelivery of Health Care, IntegratedFemaleGastroenterologistsHumansKaplan-Meier EstimateLiver NeoplasmsLogistic ModelsMaleMiddle AgedMultivariate AnalysisOdds RatioOncologistsPatient Care TeamPractice Patterns, Physicians'Proportional Hazards ModelsRetrospective StudiesRisk AssessmentRisk FactorsSpecializationSurgeonsTime FactorsTreatment OutcomeUnited StatesUnited States Department of Veterans AffairsConceptsRetrospective cohort studyMultidisciplinary tumor boardHealth system factorsHepatocellular carcinomaHCC therapyCohort studyOverall survivalTumor boardTime-varying Cox proportional hazards modelsCox proportional hazards modelActive hepatocellular carcinomaOutcomes of patientsProportional hazards modelHepatocellular carcinoma treatmentVeterans Administration HospitalSystem factorsLiver transplantationActive therapyLiver resectionTransarterial therapiesMedical oncologistsMultidisciplinary careSubspecialist carePatient survivalAblative therapyIdentifying barriers to hepatocellular carcinoma surveillance in a national sample of patients with cirrhosis
Goldberg DS, Taddei TH, Serper M, Mehta R, Dieperink E, Aytaman A, Baytarian M, Fox R, Hunt K, Pedrosa M, Pocha C, Valderrama A, Kaplan DE. Identifying barriers to hepatocellular carcinoma surveillance in a national sample of patients with cirrhosis. Hepatology 2017, 65: 864-874. PMID: 27531119, DOI: 10.1002/hep.28765.Peer-Reviewed Original ResearchMeSH KeywordsAge FactorsAgedCarcinoma, HepatocellularCohort StudiesEarly Detection of CancerFemaleHumansLinear ModelsLiver CirrhosisLiver NeoplasmsMagnetic Resonance ImagingMaleMiddle AgedMultimodal ImagingPopulation SurveillancePrevalenceProportional Hazards ModelsRisk AssessmentSeverity of Illness IndexSex FactorsTomography, X-Ray ComputedUltrasonography, DopplerUnited StatesUnited States Department of Veterans AffairsConceptsHCC surveillanceHepatocellular carcinomaPatients 75 yearsHepatocellular carcinoma surveillancePrimary care physiciansHigh-risk populationVeterans Health AdministrationOverall health care systemVeterans Administration CenterHealth care systemAbdominal ultrasoundCirrhosis patientsPrimary outcomeCare physiciansInverse associationCirrhosis diagnosisLeading causeOdds ratioPercentage of timeSurveillance ratesNumber of visitsHealth AdministrationPatientsCirrhosisCare system
2016
Recalibrating the Child–Turcotte–Pugh Score to Improve Prediction of Transplant-Free Survival in Patients with Cirrhosis
Kaplan DE, Dai F, Skanderson M, Aytaman A, Baytarian M, D’Addeo K, Fox R, Hunt K, Knott A, Mehta R, Pedrosa M, Pocha C, Valderrama A, Taddei T, for the VOCAL Study Group. Recalibrating the Child–Turcotte–Pugh Score to Improve Prediction of Transplant-Free Survival in Patients with Cirrhosis. Digestive Diseases And Sciences 2016, 61: 3309-3320. PMID: 27405990, PMCID: PMC5067291, DOI: 10.1007/s10620-016-4239-6.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedBilirubinCreatinineDisease ProgressionEnd Stage Liver DiseaseEvidence-Based MedicineFemaleHumansInternational Normalized RatioLiver CirrhosisLiver TransplantationMaleMiddle AgedOdds RatioPrognosisProportional Hazards ModelsRetrospective StudiesSerum AlbuminSeverity of Illness IndexUnited StatesVeteransConceptsTransplant-free survivalHarrell's C-statisticC-statisticPugh scoreChild-TurcotteCTP scoreHighest Harrell's C-statisticsCox proportional hazards modelEvidence-based cutpointProportional hazards modelLong-term survivalEtiology subgroupsSerum creatinineVeteran patientsLaboratory variablesRisk ratioTotal bilirubinHazards modelCirrhosisPatientsLower cutpointsDisease etiologySurvivalCutpointsScores
2015
Development and Performance of an Algorithm to Estimate the Child-Turcotte-Pugh Score From a National Electronic Healthcare Database
Kaplan DE, Dai F, Aytaman A, Baytarian M, Fox R, Hunt K, Knott A, Pedrosa M, Pocha C, Mehta R, Duggal M, Skanderson M, Valderrama A, Taddei TH, Group V. Development and Performance of an Algorithm to Estimate the Child-Turcotte-Pugh Score From a National Electronic Healthcare Database. Clinical Gastroenterology And Hepatology 2015, 13: 2333-2341.e6. PMID: 26188137, PMCID: PMC4655141, DOI: 10.1016/j.cgh.2015.07.010.Peer-Reviewed Original ResearchConceptsCTP scoreAdministrative databasesChild-TurcottePugh scoreVeterans Health Administration Corporate Data WarehouseLaboratory dataCox proportional hazards regressionSeverity of ascitesTransplant-free survivalSeverity IndexInternational normalized ratioClinical laboratory valuesHarrell's C-statisticProportional hazards regressionDiseases version 9U.S. Veterans Health AdministrationVeterans Health AdministrationMulticenter collaborative studyLarge administrative databaseLong-term survivalDisease severity scoreValidity of diagnosesCorporate Data WarehouseElectronic healthcare databasesCommon Procedural Terminology