Racial disparities in the survival time of patients with hepatocellular carcinoma and intrahepatic cholangiocarcinoma between Chinese patients and patients of other racial groups: A population‑based study from 2004 to 2013

Abstract

The aim of the present study was to investigate the racial disparities in the presentation, treatment and survival time of patients with hepatocellular carcinoma (HCC) or intrahepatic cholangiocarcinoma (ICC) between Chinese and other racial groups from the Surveillance, Epidemiology, and End Results (SEER) database between January 1st 2004, and December 31st 2013. Key covariates, including clinical presentation, treatment and survival time, were recorded and compared, demonstrating the racial differences. Kaplan-Meier analysis and Cox regression models were performed to identify these disparities in survival time. A total of 30,954 patients were identified in the SEER database. Among these, 27,767 (89.7%) had HCC and 3,187 (10.3%) had ICC. In the HCC cohort, Chinese patients had the highest survival time. Compared with the mortality risk of Chinese patients, the mortality risk of Other Asian, non-Hispanic white, Hispanic and African-American patients increased by 16.8, 35.1, 28.3 and 33.3%, respectively. Compared with other groups, Chinese patients were more likely to present with localized stage, and without vascular invasion, adjacent invasion and metastasis. In the ICC cohort, the Chinese group had improved survival time, compared with the other groups following univariate analysis, although no significant differences were observed between Chinese and Other Asian and Hispanic patients following adjusting for contributing factors. Furthermore, there was no significant differences in the presentation between the groups, which differed from the HCC analysis. In conclusion, race/ethnicity was a significant independent prognostic factor in the HCC cohort, whereas it was not significant in the ICC cohort. The synergistic effect of contributing factors, including demographic, socioeconomic, biological and treatment differences, caused the racial disparity observed in primary liver cancer survival time.

Disparities in Hepatocellular Carcinoma Survival by Insurance Status: A Population-Based Study in China

“…Furthermore, this is also the first study to examine the survival of patients with HCC in mainland China. The median survival time was 31.0 months, which was similar to that of the Chinese patients in the U.S. (34.0 months) (42). The 1-, 3-, 5-, 10-year overall survival rates in this study were 60.6, 47.3, and 40.3%, respectively, which were slightly lower than in Taiwan, China (71.68, 57.14, and 47.82%) (40).…”

Assessment of risk factors, and racial and ethnic differences in hepatocellular carcinoma

“…high unemployment, high poverty, and low education areas) compared to the general population . Race/ethnicity was a significant independent prognostic factor in the HCC . The synergistic effect of contributing factors, including demographic, socioeconomic, biological, and treatment differences, will significantly enhance the racial disparity observed in survival time of HCC patients .…”

“…Race/ethnicity was a significant independent prognostic factor in the HCC . The synergistic effect of contributing factors, including demographic, socioeconomic, biological, and treatment differences, will significantly enhance the racial disparity observed in survival time of HCC patients . Socioeconomic disparities in the survival of patients with HCC continue to exist, and these differences could result from inequities in access to care and in response to therapy .…”

Survival analysis of extrahepatic cholangiocarcinoma based on surveillance, epidemiology, and end results database

“…Several factors may play a role, including genetic factors. Previous studies have reported that Asian patient have better survival for iCCA and hepatocellular carcinoma [ 25 ]. Several genes have predictive value for CCA.…”