Racial and Ethnic Disparities in Survival Among Patients With Hepatocellular Carcinoma in the United States: A Systematic Review and Meta-Analysis

Rich, Nicole E.; Carr, Christian; Yopp, Adam C.; Marrero, Jorge A.; Singal, Amit G.

doi:10.1016/j.cgh.2020.12.029

Cited by 38 publications

(32 citation statements)

References 66 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, several biological, psychological, and social theories can also explain this phenomenon. A systematic review and meta-analysis indicated significant racial disparities in HCC prognosis in the United States, with Black patients having worse overall survival and Hispanic and Asian patients having better overall survival than White patients ( 28 ). Nikita Sandeep Wagle et al found that Black patients receive curative treatment more minor than White because of social and economic situations ( 29 ), which may partly explain this phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Nomogram to Predict Cancer-Specific Survival for Middle-Aged Patients With Early-Stage Hepatocellular Carcinoma

Wen

Tang

Luo³

2022

Front. Public Health

View full text Add to dashboard Cite

BackgroundHepatocellular carcinoma is a common cause of death in middle-aged patients. We aimed to construct a new nomogram to predict cancer-specific survival (CSS) in middle-aged patients with hepatocellular carcinoma at an early stage.MethodWe collected clinicopathological information on early middle-aged patients with hepatocellular carcinoma from the SEER database. Univariate and multivariate Cox regression models were used to screen the independent risk factors for prognosis. These risk factors were used to construct predictions of CSS in patients with hepatocellular carcinoma. Consistency index (C- index), calibration curve, area under the receiver operating curve (AUC) were used. A decision analysis curve (DCA) was used to evaluate the clinical utility of the predictive model.ResultsA total of 6,286 patients with hepatocellular carcinoma in early middle age were enrolled. Univariate and multivariate Cox regression analysis showed that sex, marriage, race, histological tumor grade, T stage, surgery, chemotherapy, AFP, and tumor size were independent risk factors for prognosis. All independent risk factors were included in the nomogram to predict CSS at 1-, 3-, and 5-years in early middle age patients with hepatocellular carcinoma. In the training cohort and validation cohort, the C-index of the prediction model was 0.728 (95%CI: 0.716–0.740) and 0.733 (95%CI: 0.715–0.751), respectively. The calibration curve showed that the predicted value of the prediction model is highly consistent with the observed value. AUC also suggested that the model has good discrimination. DCA suggested that the nomogram had better predictive power than T staging.ConclusionWe constructed a new nomogram to predict CSS in middle-aged patients with early-stage hepatocellular carcinoma. This prediction model has good accuracy and reliability, which can help patients and doctors to judge prognosis and make clinical decisions.

show abstract

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Nomogram to Predict Cancer-Specific Survival for Middle-Aged Patients With Early-Stage Hepatocellular Carcinoma

Wen

Tang

Luo³

2022

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…Our study also highlights that simply having health insurance does not remove all barriers as disparities in guideline‐concordant HCC care exist even among those with equal health coverage (in this case Medicare enrollees). ( 24 , 25 , 26 ) Further, insured patients with limited financial means may still have difficulty affording out‐of‐pocket costs for medications and clinic visits. Patients living in high‐poverty neighborhoods may also have other noninsurance‐related barriers that can result in missed visits and postponed care or shortages of physicians and subspecialists in medically underserved areas.…”

Section: Discussionmentioning

confidence: 99%

Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma

et al. 2021

Self Cite

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) disproportionately affects racial, ethnic, and low socioeconomic status (SES) populations. However, the interaction between race, ethnicity, and neighborhood SES in HCC prognosis is not well explored. This study evaluates the interaction between race and ethnicity and neighborhood SES on curative treatment utilization and overall survival among patients with HCC in the United States. We conducted a retrospective cohort study of 13,874 patients aged ≥65 years diagnosed with HCC from 2001 through 2015 using the Surveillance, Epidemiology, and End Results Medicare‐linked database. We performed multivariable logistic regression to examine the association between race, ethnicity, and curative treatment receipt across SES. We also evaluated the association between curative treatment receipt and overall survival using a Cox proportional hazards model. Among 13,874 patients, only 2,617 (18.9%) patients received curative treatment. Overall, Black patients had lower odds of receiving curative treatment than White patients (odds ratio [OR], 0.76; 95% confidence interval [CI], 0.64‐0.91). When stratified by neighborhood SES, Black patients living in high‐poverty neighborhoods had lower odds of curative treatment receipt (OR, 0.64; 95% CI, 0.49‐0.84) and worse survival (hazard ratio, 1.13; 95% CI, 1.02‐1.25). Conversely, Hispanic and Asian patients had similar curative treatment receipt compared to White patients across all socioeconomic levels. Conclusion: Disparities in curative treatment receipt and overall survival are pronounced between Black and White patients. Black–White disparities appear to be moderated by neighborhood SES and are particularly evident among those living in high‐poverty neighborhoods.

show abstract

“…Others noted that HCC is often clustered geographically in areas with low socio‐economic status. These disparities affect the prevention, early detection and outcomes of HCC 24‐27 …”

Section: Incidence and Surveillancementioning

confidence: 99%

Real‐world evidence in hepatocellular carcinoma

Mospan

Morris

Fried

2021

Liver International

View full text Add to dashboard Cite

Real‐world evidence includes all health‐related information, such as electronic health records, insurance claims, pharmacy records and wearables that are obtained outside of clinical trials. These data can provide critical insights into the natural history of disease and evaluate the safety and effectiveness of treatment regimens used in clinical practice. Real‐world data have been applied to varying degrees by global regulatory agencies to inform and expedite many phases of drug development and help refine the use of therapeutic regimens after marketing, especially in populations that are under‐represented in registration trials. For the management of hepatocellular carcinoma, early detection provides the best chance for curative therapies, whose success has been evaluated in numerous cohorts. The availability of novel systemic therapies, including kinase inhibitors and immunotherapies, has provided new treatment options and improved survival in patients with advanced stage hepatocellular carcinoma. Real‐world longitudinal observational studies can help understand the long‐term safety and effectiveness of these agents.

show abstract

Racial and Ethnic Disparities in Survival Among Patients With Hepatocellular Carcinoma in the United States: A Systematic Review and Meta-Analysis

Cited by 38 publications

References 66 publications

Development and Validation of a Nomogram to Predict Cancer-Specific Survival for Middle-Aged Patients With Early-Stage Hepatocellular Carcinoma

Development and Validation of a Nomogram to Predict Cancer-Specific Survival for Middle-Aged Patients With Early-Stage Hepatocellular Carcinoma

Racial, Ethnic, and Socioeconomic Disparities in Curative Treatment Receipt and Survival in Hepatocellular Carcinoma

Real‐world evidence in hepatocellular carcinoma

Contact Info

Product

Resources

About