African Americans with hepatocellular carcinoma have worse survival than Caucasians: A tumor registry study

Abstract

6062 Background: SEER data suggest an increasing incidence of hepatocellular carcinoma (HCC) in the US, and overall 5-year survival is less than 5%. Which subgroups of patients with HCC have the poorest prognosis is not known. Methods: To determine what factors affect survival of HCC patients and if survival has changed significantly in the last three decades, we performed a retrospective analysis of 193 consecutive patients diagnosed from 1971–2000 with HCC, identified from a hospital tumor registry. Cox regression analysis was performed to identify demographic variables prognostic for survival. Results: The study cohort comprised 193 patients, (106 Caucasians, 84 African American (AA), and 3 other). There were 73 females and 120 males. The median age at diagnosis for the cohort was 67 years (range 13–90 years). Median survival for the entire cohort was 77 days. Patients were divided into 3 groups based on decade of diagnosis. Group 1 included 47 patients diagnosed from 1971–80, group 2 had 63 patients diagnosed 1981–90, and group 3 had 83 patients diagnosed 1991–2000. Overall survival did not change over the three decades (p = 0.94) for the entire cohort and for both races. In a multivariate analysis, AA race was significantly predictive of poorer survival (HR 1.45, 95% CI 1.07–1.96, p = 0.017), but age, gender and decade of diagnosis were not independent risk factors. AA patients had a significantly lower overall survival when compared to their Caucasian counterparts only in the last decade of analysis (p = 0.026) with a trend towards significance in the second decade (p = 0.083). Conclusions: We conclude that survival for HCC patients has remained low over the last three decades, and AA race is a significant predictor of poor survival. More studies are needed to determine what biological factors lead to the poorer survival for AA patients. No significant financial relationships to disclose.