Disparities in treatment and survival in early-stage hepatocellular carcinoma in California

Gholami, Sepideh, Kleber, Kara T, Perry, Lauren M, Abidalhassan, Mustafa, McFadden, Nikia R, Bateni, Sarah B, Maguire, Frances B, Stewart, Susan L, Morris, Cyllene, Chen, Moon, Gaskill, Cameron E, Merkow, Ryan P, Keegan, Theresa H (August 2023) Disparities in treatment and survival in early-stage hepatocellular carcinoma in California. Journal of Surgical Oncology. ISSN 0022-4790

URL: https://www.ncbi.nlm.nih.gov/pubmed/37610042
DOI: 10.1002/jso.27423


BACKGROUND AND OBJECTIVES: Curative intent therapy is the standard of care for early-stage hepatocellular carcinoma (HCC). However, these therapies are under-utilized, with several treatment and survival disparities. We sought to demonstrate whether the type of facility and distance from treatment center (with transplant capabilities) contributed to disparities in curative-intent treatment and survival for early-stage HCC in California. METHODS: We performed a retrospective analysis of the California Cancer Registry for patients diagnosed with stage I or II primary HCC between 2005 and 2017. Primary and secondary outcomes were receipt of treatment and overall survival, respectively. Multivariable logistic regression and Multivariable Cox proportional hazards regression were used to evaluate associations. RESULTS: Of 19 059 patients with early-stage HCC, only 36% (6778) received curative-intent treatment. Compared to Non-Hispanic White patients, Hispanic patients were less likely, and Asian/Pacific Islander patients were more likely to receive curative-intent treatment. Our results showed that rural residence, public insurance, lower neighborhood SES, and care at non-National Cancer Institute-designated cancer center were associated with not receiving treatment and decreased survival. CONCLUSIONS: Although multiple factors influence receipt of treatment for early-HCC, our findings suggest that early intervention programs should target travel barriers and access to specialist care to help improve oncologic outcomes.

Item Type: Paper
Subjects: diseases & disorders > cancer
diseases & disorders
diseases & disorders > neoplasms
diseases & disorders > cancer > cancer types > liver cancer
diseases & disorders > cancer > cancer types
CSHL Authors:
Communities: CSHL labs > Gholami Lab
SWORD Depositor: CSHL Elements
Depositing User: CSHL Elements
Date: 23 August 2023
Date Deposited: 27 Sep 2023 18:52
Last Modified: 11 Apr 2024 13:39
PMCID: PMC10841249
Related URLs:
URI: https://repository.cshl.edu/id/eprint/41002

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