Racial Disparities in Liver Transplant for Hepatitis C-Associated Hepatocellular Carcinoma.

Autor: Bennett FJ; Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA., Keilson JM; Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA., Turgeon MK; Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA., Oppat KM; Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA., Warren EAK; Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA., Shah SA; Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Agopian VG; Department of Surgery, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA., Magliocca JF; Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA., Cameron A; Department of Surgery, Johns Hopkins, Baltimore, MD, USA., Orloff SL; Department of Surgery, Oregon Health and Science University, Portland, OR, USA., Kubal CA; Department of Surgery, Indiana University Health, Indianapolis, IN, USA., Cannon RM; Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA., Akoad ME; Department of Surgery, Lahey Hospital and Medical Center, Boston, MA, USA., Emamaullee J; Department of Surgery, Keck Hospital of University of Southern California, Los Angeles, CA, USA., Aucejo F; Department of Surgery, Cleveland Clinic, Cleveland, OH, USA., Vagefi PA; Department of Surgery, UT Southwestern Medical Center, Dallas, TX, USA., Nguyen MH; Department of Medicine, Stanford University Medical Center, Palo Alto, CA, USA., Dhanireddy K; Department of Surgery, Tampa General Hospital, Tampa, FL, USA., Kazimi MM; Department of Surgery, Piedmont Healthcare, Atlanta, GA, USA., Sonnenday CJ; Department of Surgery, University of Michigan, Ann Arbor, MI, USA., Foley DP; Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA., Abdouljoud M; Department of Surgery, Henry Ford Health System, Detroit, MI, USA., Sudan DL; Department of Surgery, Duke University School of Medicine, Durham, NC, USA., Humar A; Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA., Doyle MBM; Department of Surgery, Washington University School of Medicine at St. Louis, St. Louis, MO, USA., Chapman WC; Department of Surgery, Washington University School of Medicine at St. Louis, St. Louis, MO, USA., Maithel SK; Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA. smaithe@emory.edu.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2024 Oct 16. Date of Electronic Publication: 2024 Oct 16.
DOI: 10.1245/s10434-024-16317-2
Abstrakt: Background: In the United States, hepatitis C virus-associated hepatocellular carcinoma incidence and mortality are highest among minorities. Socioeconomic constraints play a major role in inequitable treatment. We evaluated the association between race/ethnicity and outcomes in a population that overcame treatment barriers.
Methods: We report a retrospective cohort study of 666 patients across 20 institutions in the United States Hepatocellular Carcinoma Liver Transplantation Consortium from 2015 to 2019 with hepatitis C virus-associated hepatocellular carcinoma who completed direct-acting antiviral therapy and underwent liver transplantation. Patients were excluded if they had a prior liver transplantation, hepatocellular carcinoma recurrence, no prior liver-directed therapy, or if race/ethnicity data were unavailable. Patients were stratified by race/ethnicity. Primary outcomes were recurrence-free survival and overall survival, and secondary outcome was major postoperative complication.
Results: Race/ethnicity was not associated with differences in 5-year recurrence-free survival (White 90%, Black 88%, Hispanic 92%, Other 87%; p = 0.85), overall survival (White 85%, Black 84%, Hispanic 84%, Other 93%; p = 0.70), or major postoperative complication.
Conclusions: Race/ethnicity was not associated with worse oncologic or postoperative outcomes among those who completed direct-acting antiviral therapy and underwent liver transplantation, suggesting that overcoming socioeconomic constraints equalizes outcomes across racial/ethnic groups. Eliminating barriers that prohibit care access among minorities must be a priority.
(© 2024. Society of Surgical Oncology.)
Databáze: MEDLINE
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