Published online Dec 28, 2017. doi: 10.4254/wjh.v9.i36.1346
Peer-review started: September 22, 2017
First decision: November 3, 2017
Revised: November 14, 2017
Accepted: December 4, 2017
Article in press: December 5, 2017
Published online: December 28, 2017
To evaluate disparities in the treatment of hepatocellular carcinoma (HCC) based on gender.
A retrospective database analysis using the Nationwide Inpatient Sample (NIS) was performed between 2010 and 2013. Adult patients with a primary diagnosis of hepatocellular carcinoma determined by International Classification of Disease 9 (ICD-9) codes were included. Univariate analysis and multivariate logistic regressions were performed to analyze differences in treatment, mortality, features of decompensation, and metastatic disease based on the patient’s gender.
The analysis included 62582 patients with 45908 men and 16674 women. Women were less likely to present with decompensated liver disease (OR = 0.84, P < 0.001) and had less risk of inpatient mortality when compared to men (OR = 0.75, P < 0.001). Women were more likely to receive inpatient resection (OR = 1.31, P < 0.001) or an ablation (OR = 1.22, P = 0.028) than men. There was no significant difference between men and women in regard to liver transplantation and transcatheter arterial chemoembolization (TACE).
Gender impacts treatment for hepatocellular carcinoma. Women are more likely to undergo an ablation or resection then men. Gender disparities in transplantation have resolved.
Core tip: Previous studies have evaluated treatment disparities in the treatment of hepatocellular carcinoma (HCC) based on gender. Despite recent emphasis to ensure equal care for all patients this study continues to show disparities in the treatment of HCC, specifically in resection and ablation. Gender disparities in the treatment of HCC with transplantation have resolved.