Hepatocellular carcinoma survival rates increased during 30-year period

BOSTON — Overall survival rates of patients with hepatocellular carcinoma increased markedly between 1977 and 2006, but improvement was impacted by factors including age and ethnicity, according to data presented at The Liver Meeting.

Researchers evaluated data in 5-year intervals on 35,892 patients with hepatocellular carcinoma (HCC) collected from the National Cancer Institute’s Surveillance, Epidemiology and End Results database between 1977 and 2006.

“Epidemiological evidence suggests that the incidence and mortality rates of HCC have continued to rise in the United States,” the researchers wrote. “However, data on trends in survival of patients with HCC during the same period is unknown.”

Overall survival rates within 1 year increased from 13.7% of patients for the period 1977 through 1981 to 40% for 2002 through 2006. Five-year rates also increased from 2.2% to 15.9% during the same periods. Localized and regional HCC survival rates improved for both 1 and 5 years, but metastatic HCC survival rates remained low. Investigators noted that neither the 1- nor 5-year survival rate improved among patients aged younger than 40 years, but patients aged older than 40 years had significantly higher 5-year survival rates from 1997 through 2006 compared with earlier periods.

Differences in survival rates according to ethnicity were observed, with the poorest survival rates among African-Americans, and the best among other, non-white ethnic groups, including Asians, Pacific Islanders and Native Americans.

Investigators noted no significant differences in the overall 5-year survival rates for men and women from 2002-2006 (15.5% in men compared with 17% in women). African-American women, however, had markedly better survival rates at 5 years compared with African-American men (18.3% vs. 8.3%, P<.05), but differences in 5-year survival between white men and white women (15% vs. 15.5%), or between men and women in other ethnic groups (21.5% vs. 20.10%), were not statistically significant.

“The only thing that we lack here is what kind of treatments actually affect these outcomes, since the database does not carry all kinds of treatment modalities,” researcher Pardha Devaki, MD, MS, a resident in the department of internal medicine at Detroit Medical Center, told Healio.com. “That’s something we’d like to include in [further] analysis. We can clearly see that racial disparities still persist that effect analysis, and … patients who have poor survival rates, like African-Americans, should have a high index of suspicion if they have any risk factors for HCC.”

For more information:

Devaki P. P550: Trends in Survival of Patients with Hepatocellular Carcinoma Between 1977 and 2006 in the United States. Presented at: The Liver Meeting 2012; Nov. 9-13, Boston.