Hepatocellular Carcinoma and Associated Clinical Features in Latino and Caucasian Patients from a Single Center

Abstract

Introduction and aim. Hepatocellular carcinoma (HCC) is the most common type of liver cancer in adults and has seen a rapid increase in incidence in the United States. Racial and ethnic differences in HCC incidence have been observed, with Latinos showing the greatest increase over the past four decades, highlighting a concerning health disparity. The goal of the present study was to compare the clinical features at the time of diagnosis of HCC in Latino and Caucasian patients. Material and methods. We retrospectively screened a total of 556 charts of Latino and Caucasian patients with HCC. Results. The mean age of HCC diagnosis was not significantly different between Latinos and Caucasians, but Latinos presented with higher body mass index (BMI). Rates of hypertension, diabetes, and hyperlipidemia were similar in the two groups. The most common etiology of liver disease was alcohol drinking in Latinos, and chronic hepatitis C in Caucasian patients. Non-Alcoholic Steatohepatitis (NASH) was the associated diagnosis in 8.6% of Latinos and 4.7% of Caucasians. Interestingly, alpha-fetoprotein (AFP) levels at time of diagnosis were higher in Latino patients compared to Caucasians, but this difference was evident only in male patients. Multifocal HCC was slightly more frequent in Latinos, but the two groups had similar cancerous vascular invasion. Latino patients also presented with higher rates of both ascites and hepatic encephalopathy. Conclusion. Latino and Caucasian patients with HCC present with a different profile of etiologies, but cancer features appear to be more severe in Latinos.

Clinical Manifestations and Laboratory Examination Findings of Hepatocellular Carcinoma at a Tertiary Care Facility in Bandung: An Annual Observation Study

“…This finding is similar to previous studies reported in different countries or continents, which indicates HCC as a global problem worldwide. 12,13 In general, the prevalence of hepatitis B in Indonesia is higher than other hepatitis infections and hepatitis B is the most common etiology of HCC, as previously reported. 9,14 Furthermore, the most common symptom in HCC patients in our study was abdominal pain, consistent with the study from Saudi Arabia.…”

“…18 Albumin levels in this study were found to be decreased in most patients, which is consistent with finding from the United States. 13 In this study, most of the patients had multinodular tumors. However, a study in Jakarta resulted that singular nodules were more common than multiple.…”

Risk Factors for Hepatocellular Carcinoma in Patients With Non-Alcoholic Fatty Liver Disease

“…Furthermore, the relationship between obesity and HCC risk may differ according to ancestry, with a greater association among Americans, Japanese, whites, and Latin American men but not in African-descendant men; and may be related to ancestry and gender variances in fat body distribution (35) . A previous study suggested that obesity was positively associated with HCC in whites, but not in African Americans (1,41) . Compared to whites in similar conditions, Latinos and Asians are more likely than African Americans to accumulate fatty cells in the abdominal visceral compartment and the liver (1,41) .…”

Socioeconomic and racial/ethnic disparities in receipt of palliative care among patients with metastatic hepatocellular carcinoma

“…Our study found that Hispanics were significantly less likely to receive PC than NHWs. This finding is particularly concerning given that the burden of HCC among the Hispanic population has been growing steadily, and Hispanics now have 2.5 times the incidence of HCC than NHW 20–24 . Several social determinants of health may explain this PC utilization disparity, including medical literacy/language barriers and ability to access high‐quality cancer care.…”

“…This finding is particularly concerning given that the burden of HCC among the Hispanic population has been growing steadily, and Hispanics now have 2.5 times the incidence of HCC than NHW. [20][21][22][23][24] Several social determinants of health may explain this PC utilization disparity, including medical literacy/language barriers and ability to access high-quality cancer care. A 2019 study of the National Cancer Institute's Health Information National Trends Survey found that 85% of Hispanic patients had no knowledge about PC.…”