Disparities in care for patients with curable hepatocellular carcinoma

Abstract

Fewer than half of patients with curable HCC receive surgery, possibly as a result of multiple socioeconomic variables. Past these barriers to care, survival is related to adequate and reliable treatment. Further efforts should address these disparities in treatment decisions.

Hepatocellular carcinoma surveillance, early detection and survival in a privately insured US cohort

“…This value is similar to what was previously reported in other analyses of commercial insurance claims database (ie Truven) and systematic reviews . Disparities in healthcare utilization and delivery exist based on race, insurance type, geography (eg urban vs rural) and treatment setting (eg academic vs community) among patients with HCC . In addition, patients often have misconceptions about HCC and surveillance, and patient‐perceived barriers to HCC surveillance have been associated with lower HCC surveillance rates .…”

“…17,20 Disparities in healthcare utilization and delivery exist based on race, insurance type, geography (eg urban vs rural) and treatment setting (eg academic vs community) among patients with HCC. [34][35][36] In addition, patients often have misconceptions about HCC and surveillance, and patient-perceived barriers to HCC surveillance have been associated with lower HCC surveillance rates. 37 Previous studies found that seeing a non-gastroenterology provider, greater age, compensated cirrhosis, non-Caucasian race and lower socioeconomic status are associated with decreased adherence to HCC surveillance.…”

Ablation approach for primary liver tumors: Peri‐operative outcomes

“…Furthermore, peri‐procedural outcomes such as short‐term morbidity as well as hospital length of stay, return of bowel function, readmission rates, and even hospital costs have been shown to be improved with laparoscopic hepatectomy . Liver ablation is a key treatment modality for primary liver cancer, representing therapy for up to 30% of cases, and is performed via percutaneous, laparoscopic, and open approaches . However, periprocedural outcomes following liver ablation are not well defined.…”

“…and open approaches. 8,9 However, periprocedural outcomes following liver ablation are not well defined. Descriptive statistics and logistic regression were performed to adjust for specific patient factors.…”

External radiation or ablation for solitary hepatocellular carcinoma: A survival analysis of the SEER database

“…Hepatic resection and transplantation offer the greatest overall survival (OS) advantage for patients with HCC. However, ablation represents treatment for approximately 30% of small (<5 cm) HCC lesions . A 2010 randomized controlled trial of HCC patients with lesions conforming to the Milan criteria compared resection to ablation, and demonstrated superior OS and recurrence‐free survival for surgical resection.…”