Surgical resection of early stage hepatocellular carcinoma improves patient survival at safety net hospitals

Background and Objectives Surgical resection is indicated for hepatocellular carcinoma (HCC) patients with Child A cirrhosis. We hypothesize that surgical intervention and survival are limited by advanced HCC presentation at safety net hospitals (SNHs) versus academic medical centers (AMCs). Methods Patients with HCC and Child A cirrhosis in the US Safety Net Collaborative (2012–2014) were evaluated. Demographics, clinicopathologic features, operative characteristics, and outcomes were compared between SNHs and AMCs. Liver transplantation was excluded. Kaplan–Meier and Cox proportional‐hazards models were used to identify the effect of surgery on overall (OS). Results A total of 689 Child A patients with HCC were identified. SNH patients frequently presented with T3/T4 stage (35% vs. 24%) and metastases (17% vs. 8%; p