Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Oct 15;113(8):2173-9.
doi: 10.1002/cncr.23766.

Decreasing disparity in liver transplantation among white and Asian patients with hepatocellular carcinoma : California, 1998-2005

Anthony S Robbins  1 , Michael F Daily, Christopher A Aoki, Moon S Chen Jr, Christoph Troppmann, Richard V Perez
Affiliations

Decreasing disparity in liver transplantation among white and Asian patients with hepatocellular carcinoma : California, 1998-2005

Anthony S Robbins et al. Cancer. .

Abstract

Background: A preliminary study using national cancer surveillance data from 1998 through 2002 suggested that there were significant differences between non-Hispanic whites ('whites') and Asian/Pacific Islanders (APIs) in the use of liver transplantation as a treatment for hepatocellular carcinoma (HCC).

Methods: The objective of the current study was to examine whether differences in liver transplantation between whites and APIs with HCC were changing over time. By using a population-based, statewide cancer registry, data were obtained on all HCC cases diagnosed in California between 1998 and 2005, and the study was limited to white and API patients with nonmetastatic HCC who had tumors that measured < or = 5 cm in greatest dimension (n = 1728 patients).

Results: From 1998 through 2003 (n = 1051 patients), the odds of undergoing liver transplantation were 2.56 times greater for white patients than for API patients (95% confidence interval [CI], 1.72-3.80 times higher), even after adjusting for age, sex, marital status, year of diagnosis, TNM stage, and tumor grade. In contrast, during 2004 and 2005 (n = 677 patients), there were no significant differences in the odds of undergoing liver transplantation. Between 2002 and 2004, changes in liver transplantation policy assigned priority points to patients with HCC (initially to stage I and II, then to stage II only). After the policy changes, API patients with HCC experienced a significant increase in stage II diagnoses, whereas white patients did not.

Conclusions: In California, there was a large and significant disparity in the rate of liver transplantation among white and API patients with HCC from 1998 through 2003 but not during 2004 and 2005. Changes in liver transplantation policy from 2002 through 2004 may have played a role in decreasing this difference.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Unadjusted Differences in Liver Transplantation among White and API* Patients with Hepatocellular Carcinoma,† California, 1998–2005 (n = 1728) * White denotes non-Hispanic white and API denotes Asian/Pacific Islander. † Only patients without nodal or distant metastasis and tumor size ≤ 5.0 cm were included in the analysis.
See this image and copyright information in PMC

References

    1. National Cancer Institute Fact Book 2006. Bethesda, MD: National Institutes of Health; 2007.
    1. El-Serag HB, Mason AC, Key C. Trends in survival of patients with hepatocellular carcinoma between 1977 and 1996 in the United States. Hepatology. 2001;33:62–65. - PubMed
    1. Wall WJ, Marotta PJ. Surgery and transplantation for hepatocellular carcinoma. Liver Transpl. 2000;6(Suppl 2):S16–S22. - PubMed
    1. Patt CH, Thuluvath PJ. Role of liver transplantation in the management of hepatocellular carcinoma. J Vasc Interv Radiol. 2002;13:S205–S210. - PubMed
    1. Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334:693–699. - PubMed

Publication types