Treatment choices and outcomes of non-metastatic hepatocellular carcinoma patients in relationship to neighborhood socioeconomic status: a population-based study.

Abstract:

OBJECTIVE:To assess the impact of socioeconomic status (SES) on treatment choices and outcomes of hepatocellular carcinoma (HCC) patients treated with local therapies (ablation or surgery). METHODS:Surveillance, Epidemiology and End Results (SEER) specialized socioeconomic database was accessed. Cases with non-metastatic HCC treated with ablation or surgery between 2000 and 2015 were included. Socioeconomic index stratified patients into three groups (1-3) where group-1 has the lowest SES and group-3 has the highest SES. Impact of SES on the choice of local treatment was assessed in a multivariate logistic regression model. Likewise, the impact of SES on liver cancer-specific survival was assessed in a multivariate Cox regression model. Competing risk analysis for the impact of SES on liver cancer mortality was additionally conducted. RESULTS:A total of 14,333 non-metastatic HCC patients were included in the final analysis. In a multivariable logistic regression analysis, SES did not predict the type of local treatment (ablation versus surgical treatment) (adjusted odds ratio for group 1 versus group 3: 0.931; 95% CI 0.854-1.015; P = 0.10). On the other hand, and in a multivariable Cox regression analysis, lower socioeconomic status was associated with worse liver cancer-specific survival (adjusted hazard ratio for group-1 versus group-3: 6.448; 95% CI 5.696-7.298; P < 0.01). Likewise, and in competing risk analysis, lower socioeconomic group was associated with worse liver cancer-specific survival (adjusted sub-distribution hazard ratio for group-1 versus group-3: 1.102; 95% CI 1.016-1.196; P = 0.019). CONCLUSIONS:Lower SES is associated with worse liver cancer-specific survival among non-metastatic HCC patients treated with ablation or surgery.

journal_name

Int J Clin Oncol

authors

Abdel-Rahman O

doi

10.1007/s10147-020-01616-x

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

861-866

issue

5

eissn

1341-9625

issn

1437-7772

pii

10.1007/s10147-020-01616-x

journal_volume

25

pub_type

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