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Racial, ethnic disparities exist for early-stage HCC survival rates

Mathur AK. Arch Surg. 2010;145:1158-1163.

Issue: January 25, 2011

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Mortality rates for early-stage hepatocellular carcinoma were nearly 25% higher in blacks than whites in a base survival model, according to recent study results.

Researchers from Michigan evaluated 13,244 patients with early-stage hepatocellular carcinoma (HCC) for differences in survival by race or ethnicity when taking into account use of invasive therapy and treatment benefit.

Invasive therapy options included tumor ablation, hepatectomy and liver transplant. Ethnicities were defined as white, black, Asian, Hispanic or other.

Compared with white patients, black (HR=1.24; 95% CI, 1.15-1.33) and Hispanic (HR=1.08; 95% CI, 1.01-1.15) patients had higher mortality rates in the base survival model. In this same model, Asian patients had lower mortality rates than whites (HR=0.87; 95% CI, 0.82-0.93).

After comparing for treatment effect, blacks had a 12% higher mortality rate (HR=1.11; 95% CI, 1.03-1.20) than whites. Other results of the treatment-stratified analysis indicated that Hispanics and whites had a similar mortality rate (HR=0.97; 95% CI, 0.91-1.04), and Asians had a 16% lower mortality rate than whites (HR=0.84; 95% CI, 0.79-0.89).

Higher proportions of untreated patients were observed in black and Hispanic populations compared with whites, Asians and others (P<.001).

Results indicated that 32.8% of patients had received invasive therapy. Five-year OS was 17.9% across the study population. White patients had an 18.2% OS rate compared with 12.2% among blacks, 15.2% among Hispanics, 22% among Asians and 17.1% for other patients (P<.001).

Asians had the longest median survival at 15 months compared with 8 months among blacks. Whites and Hispanics each had 10-month median survival periods.

The aim of the retrospective cohort study, which involved SEER HCC data, was to determine whether controlling for differences in the use of invasive therapy affected racial or ethnic differences among patients.

Eligible patients had been diagnosed with stage I or II HCC between Jan. 1, 1995, and Dec. 31, 2006.

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