Association Between Hepatic Malignant Tumors and Partial Oncological Hepatectomy in Brazil: A Time Analysis From 2021 to 2023

PURPOSE Hepatocellular carcinoma is the most common type of hepatic cancer, and it is an aggressive malignant tumor with high lethality. Although the only potential curative treatment for hepatocellular carcinoma is tumor resection, only a few percent of cases are manageable to operative treatment. This study aims to analyze the number of diagnoses of hepatic tumors and the variation of partial hepatectomies performed throughout 3 years among Brazilian regions. METHODS Data was collected from DATASUS, a Brazilian Health Ministry database, from 2021 to 2023. In this cross-sectional design, the study analyzed partial hepatectomies in oncology, in addition to the number of diagnoses, comparing the number of surgical procedures among Brazilian regions (North, Northeast, Southeast, South, and Midwest) between the years. Statistical analysis was performed using R statistical software 4.2.1, considering significant p values < 0.05. RESULTS In the years 2021, 2022, and 2023, a total number of 10,144 malignant hepatic tumors were diagnosed. In the same period, 3,017 partial hepatectomies in oncology were performed (p < 0.001). The lowest number of surgeries performed was 951 in the year 2021, which could have been influenced by the Pandemic of COVID-19, and the highest was 1,098, in 2023. The variance in the number of surgeries performed was analyzed with the two-way ANOVA method, which presented statistical significance in the variation between regions over the years (p < 0.001). However, concerning the years analyzed, the difference was not significant (p = 0.052). Tukey post hoc test was also performed, which showed a significant association between all the regions, except for the interaction between North and Midwest (p = 0.982). The interaction between years was not statistically significant. CONCLUSION Hepatic tumors are potentially curable if discovered in their initial stages. The number of partial hepatectomies in oncology performed was statistically significant compared to the number of diagnoses, confirming that only a small number of cases are managed with surgery. The variation between the regions was also significant, showing an unequal distribution of surgeries performed between Brazilian regions. Further studies are needed to understand the factors behind those numbers.