Racial and Ethnic Differences in Liver Transplantation and Post–Liver Transplant Survival Among Patients With Hepatocellular Carcinoma

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-11-06 DOI:10.1002/cam4.70298

Udhayvir S. Grewal, Apoorva K. Chandar, Shiva J. Gaddam, Abdul Rahman Al Armashi, Akram Alkreshi, Subhash C. Garikipati

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Abstract

Background

Racial and ethnic disparities in diagnosis and overall outcomes for HCC are well known. We present updated real-world data on racial or ethnic differences in LT and post-LT survival among patients with HCC in a large population-based database.

Methods

We used the TriNetX database to retrospectively identify patients who had HCC (ICD-10 C22.0, C22.8) and underwent LT (CPT codes 47,135, 47,140, 47,140, 47,141, 47,142) from 2012 to 2022 and compared outcomes across racial and ethnic subgroups.

Results

Majority of the patients were Caucasians (2403/2901, 84.8%), followed by African Americans (267/2901, 9.2%) Hispanic/Asian (231/2901, 7.9%). At follow up of 5 years, we noted no significant difference in mortality between AA and Caucasian patients [HR = 1.087 (95% CI 0.76, 1.56, p = 0.59)] as well as Hispanic/Asian and Caucasian patients [HR = 1.14 (95% CI 0.73, 1.78, p = 0.10)].

Conclusions

These results indicate that stringent implementation of policies aimed at ensuring equitable access to LT may contribute to bridging disparities in overall outcomes in HCC.

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肝细胞癌患者肝移植和肝移植后存活率的种族和民族差异。

背景：众所周知，HCC 的诊断和总体预后存在种族和民族差异。我们在一个基于人口的大型数据库中提供了最新的真实世界数据，说明HCC患者在LT和LT后存活率方面的种族或民族差异：我们使用 TriNetX 数据库回顾性地识别了 2012 年至 2022 年期间患有 HCC（ICD-10 C22.0、C22.8）并接受了 LT（CPT 编码 47,135、47,140、47,140、47,141、47,142）治疗的患者，并比较了不同种族和民族亚群的治疗效果：大多数患者是白种人（2403/2901，84.8%），其次是非裔美国人（267/2901，9.2%）和西班牙裔/亚洲人（231/2901，7.9%）。在 5 年的随访中，我们发现非裔美国人和高加索人患者的死亡率[HR = 1.087 (95% CI 0.76, 1.56, p = 0.59)]以及西班牙裔/亚洲人和高加索人患者的死亡率[HR = 1.14 (95% CI 0.73, 1.78, p = 0.10)]没有显著差异：这些结果表明，严格执行旨在确保公平获得 LT 的政策可能有助于缩小 HCC 总体预后的差距。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.