P4607 - Disparities in Locoregional Therapy Type or Curative Intent for Hepatocellular Carcinoma by Race or Ethnicity

Sydney Power, MD¹, Yue Jiang, PhD², Chidi Iloabachie, BS³, Arjun Juneja, BS⁴, Merete Lund, MD¹, Gabe Lupu, MD¹, Joyce Badal, MD⁴, David Seligson, MS⁵, Hanna Sanoff, MD¹, David Mauro, MD¹, David Gerber, MD⁶, Ted Yanagihara, MD¹, A. Sidney Barritt, MD, MSCR¹, Andrew Moon, MD, MPH^1
1University of North Carolina, Chapel Hill, NC; ²Duke University, Chapel Hill, NC; ³University of North Carolina at Chapel Hill School of Medicine, Carrboro, NC; ⁴University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC; ⁵Center for Gastrointestinal Biology and Disease, University of North Carolina, Chapel Hill, NC; ⁶University of Cincinnati, Chapel Hill, NC

Introduction: Hepatocellular carcinoma (HCC) has a disproportionate burden in Black and Hispanic patients. Studies have suggested that patients in such groups are less likely to receive curative treatment, and few clinical implications exist to mitigate these disparities. To better understand potential inequities in HCC treatment, we aimed to characterize disparities along racial and ethnic lines in locoregional therapy type or curative intent for HCC in a single tertiary care center.

Methods: We conducted a single center retrospective cohort study of 338 adult patients who underwent locoregional therapy for HCC at a large tertiary center between 1/1/2014 and 12/31/2021. Treatment types include laparoscopic ablation, percutaneous ablation, bland embolization, transarterial chemoembolization (TACE), transarterial radioembolization (TARE/Y90), and stereotactic body radiation therapy (SBRT). We compared the type of first treatment received among Black/non-Hispanic, White/non-Hispanic, and Hispanic patients. We used a multivariable Cox model to examine associations between racial/ethnic group and death, adjusting for age, treatment, BCLC stage, Child Pugh class and type of medical insurance.

Results: Of the 338 patients, 73 were identified as Black/non-Hispanic, 223 were identified as White/non-Hispanic, 17 were identified as Hispanic, and 25 did not identify in any these categories. The multivariable Cox model for suggested higher hazard of death among patients undergoing bland embolization vs. laparoscopic ablation (adjusted hazard ratio (aHR) 2.51; 95% CI: 1.06 – 5.95) and patients in BCLC stage B vs. stage 0 (aHR 2.21; 95% CI: 1.08 – 4.52). Although adjusted hazard of death was higher among Black/non-Hispanic (aHR 1.06; 95% CI: 0.69 – 1.61) and Hispanic (aHR 1.18; 95% CI: 0.52 – 2.65) patients compared to White non-Hispanic patients, this was not a statistically significant difference.

Discussion: Although Black and Hispanic patients received curative treatment less often than White non-Hispanic patients, we failed to detect a statistically significant relationship between race/ethnicity and death. Regardless, to provide equitable care, clinicians should be aware of these trends and further study ways to mitigate outcome disparities in HCC for patients in racial and ethnic minority groups.


Disclosures:


Sydney Power, MD¹, Yue Jiang, PhD², Chidi Iloabachie, BS³, Arjun Juneja, BS⁴, Merete Lund, MD¹, Gabe Lupu, MD¹, Joyce Badal, MD⁴, David Seligson, MS⁵, Hanna Sanoff, MD¹, David Mauro, MD¹, David Gerber, MD⁶, Ted Yanagihara, MD¹, A. Sidney Barritt, MD, MSCR¹, Andrew Moon, MD, MPH¹. P4607 - Disparities in Locoregional Therapy Type or Curative Intent for Hepatocellular Carcinoma by Race or Ethnicity, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.