Published online Mar 8, 2017. doi: 10.4254/wjh.v9.i7.391
Peer-review started: September 28, 2016
First decision: October 20, 2016
Revised: December 29, 2016
Accepted: January 16, 2017
Article in press: January 18, 2017
Published online: March 8, 2017
To compare features of hepatocellular carcinoma (HCC) in Hispanics to those of African Americans and Whites.
Patients treated for HCC at an urban tertiary medical center from 2005 to 2011 were identified from a tumor registry. Data were collected retrospectively, including demographics, comorbidities, liver disease characteristics, tumor parameters, treatment, and survival (OS) outcomes. OS analyses were performed using Kaplan-Meier method.
One hundred and ninety-five patients with HCC were identified: 80.5% were male, and 22% were age 65 or older. Mean age at HCC diagnosis was 59.7 ± 9.8 years. Sixty-one point five percent of patients had Medicare or Medicaid; 4.1% were uninsured. Compared to African American (31.2%) and White (46.2%) patients, Hispanic patients (22.6%) were more likely to have diabetes (P = 0.0019), hyperlipidemia (P = 0.0001), nonalcoholic steatohepatitis (NASH) (P = 0.0021), end stage renal disease (P = 0.0057), and less likely to have hepatitis C virus (P < 0.0001) or a smoking history (P < 0.0001). Compared to African Americans, Hispanics were more likely to meet criteria for metabolic syndrome (P = 0.0491), had higher median MELD scores (P = 0.0159), ascites (P = 0.008), and encephalopathy (P = 0.0087). Hispanic patients with HCC had shorter OS than the other racial groups (P = 0.020), despite similarities in HCC parameters and treatment.
In conclusion, Hispanic patients with HCC have higher incidence of modifiable metabolic risk factors including NASH, and shorter OS than African American and White patients.
Core tip: This is a retrospective study evaluating features of hepatocellular carcinoma (HCC) in Hispanics compared to those of African Americans and Whites. This large single institution study found that Hispanic patients with HCC presented with more modifiable risk factors, more advanced liver disease, and shorter survival compared to African American and White patients with HCC. Early identification and intervention upon modifiable risk factors may ameliorate HCC development and HCC morbidity in Hispanic patients.