HCC Surgery Depends on Race, Socioeconomics, Hospital Type

Race, socioeconomic status, and hospital type predict surgery for hepatocellular carcinoma

FRIDAY, July 22 (HealthDay News) -- Only a small proportion of patients with hepatocellular carcinoma (HCC) undergo surgical treatment, which varies significantly with race, socioeconomic status, and type of hospital, according to a study published in the July issue of the Archives of Surgery.

Yulia Zak, M.D., from the Stanford University Medical Center in California, and colleagues investigated the use of surgical therapies for HCC and evaluated the correlation of various patients and hospital characteristics with the receipt of these interventions. California cancer registry data from 12,148 cases of HCC were linked to the California Office of Statewide Health Planning and Development patient discharge abstracts between 1996 and 2006. The major outcome measures were receipt of liver transplant, hepatic resection, or local ablation.

The investigators identified 2,390 (20 percent) cases of surgical interventions. Of these, 2.56 percent received liver transplants, 10.8 percent underwent resection, and 6.35 percent had local ablation. Compared to African-American and Hispanic patients, transplantation was more common in white patients, and hepatectomy or ablation were more common in white and Asian/pacific Islander patients. Apparent differences in surgical intervention by race/ethnicity decreased after adjusting for patients' socioeconomic and insurance status. Surgery was significantly less common in patients with lower socioeconomic status, and no private insurance, and was significantly less likely to be offered in Disproportionate Share Hospitals, and public, rural, and nonteaching hospitals.

"There are significant racial, socioeconomic, and hospital-type disparities in surgical treatment of HCC," the authors write.

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