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Racial Disparities in Liver Transplant for Hepatitis C-Associated Hepatocellular Carcinoma
Frances J Bennett1, Jessica M Keilson1, Michael K Turgeon1
1Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, GA, USA.
Annals of Surgical Oncology
|October 16, 2024
Summary
Hepatitis C virus-associated liver cancer outcomes were similar across racial/ethnic groups after overcoming treatment barriers. Addressing socioeconomic constraints is key to achieving equitable care and improving survival rates for all patients.
Area of Science:
- Hepatology
- Oncology
- Transplantation Medicine
Background:
- Hepatocellular carcinoma (HCC) incidence and mortality disproportionately affect minority populations in the US.
- Socioeconomic factors significantly contribute to disparities in HCC treatment and outcomes.
- This study examines racial/ethnic disparities in HCC outcomes among patients who successfully navigated treatment barriers.
Purpose of the Study:
- To evaluate the association between race/ethnicity and outcomes in patients with hepatitis C virus-associated HCC.
- To determine if overcoming socioeconomic constraints equalizes oncologic and postoperative outcomes across diverse patient groups.
Main Methods:
- Retrospective cohort study of 666 patients with hepatitis C virus-associated HCC who completed direct-acting antiviral therapy and liver transplantation.
- Data collected from 20 institutions within the United States HCC Liver Transplantation Consortium (2015-2019).
- Patients stratified by race/ethnicity; primary outcomes included recurrence-free and overall survival; secondary outcome was major postoperative complications.
Main Results:
- No significant association found between race/ethnicity and 5-year recurrence-free survival (90% White, 88% Black, 92% Hispanic, 87% Other; p = 0.85).
- Overall survival rates also showed no significant differences across racial/ethnic groups (85% White, 84% Black, 84% Hispanic, 93% Other; p = 0.70).
- Major postoperative complications did not differ significantly by race/ethnicity.
Conclusions:
- Race/ethnicity was not linked to adverse oncologic or postoperative outcomes in patients who completed therapy and underwent liver transplantation.
- Overcoming socioeconomic barriers appears to equalize health outcomes across racial/ethnic groups.
- Prioritizing the elimination of healthcare access barriers for minority populations is crucial for achieving health equity.
