Clinical Presentation of Hepatocellular Carcinoma in African Americans vs. Caucasians: A Retrospective Analysis
Hepatocellular carcinoma (HCC) remains an important form of cancer-related morbidity and mortality in the U.S. and worldwide. Previous U.S.-based studies on survival suggest ethnic disparities in HCC patients, but the complex interplay of multiple factors that contribute are still incompletely under...
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doaj-135cefb1722f4d6cbcd0c2ab8b75760a2021-09-26T00:54:59ZengMDPI AGPathophysiology1873-149X2021-08-01282638739910.3390/pathophysiology28030026Clinical Presentation of Hepatocellular Carcinoma in African Americans vs. Caucasians: A Retrospective AnalysisHrishikesh Samant0Kapil Kohli1Krunal Patel2Runhua Shi3Paul Jordan4James Morris5Annie Schwartz6Jonathan Steven Alexander7Section of Gastroenterology and Hepatology, Departments of Medicine, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103, USASection of Gastroenterology and Hepatology, Departments of Medicine, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103, USALane Gastroenterology, Zachary, LA 70791, USADepartment of Molecular and Cellular Physiology, LSU Health Sciences Center Shreveport, Shreveport, LA 71130, USASection of Gastroenterology and Hepatology, Departments of Medicine, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103, USASection of Gastroenterology and Hepatology, Departments of Medicine, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103, USADepartment of Molecular and Cellular Physiology, LSU Health Sciences Center Shreveport, Shreveport, LA 71130, USASection of Gastroenterology and Hepatology, Departments of Medicine, Ochsner-LSU Health Sciences Center in Shreveport, Shreveport, LA 71103, USAHepatocellular carcinoma (HCC) remains an important form of cancer-related morbidity and mortality in the U.S. and worldwide. Previous U.S.-based studies on survival suggest ethnic disparities in HCC patients, but the complex interplay of multiple factors that contribute are still incompletely understood. Here we considered the influences of risk factors contributing towards HCC survival, including ethnic background, over ten years at a premier academic medical center with a majority (57.20%) African American (AA) population. Retrospective HCC data were collected from 2008–2018 at LSUHSC-Shreveport, an urban tertiary medical center. Data included demographics, comorbidities, liver disease characteristics, and tumor parameters. Statistical analysis was performed using Chi Square and one-way ANOVA. Results: 229 HCC patients were identified (male 78.6%). The mean HCC age at diagnosis was 61 years (SD = 7.3). Compared to non-Hispanic Caucasians (42.7%), AA patients (57.2% of total) were older at presentation, had more frequent diabetes/dyslipidemia/NAFLD (45 (34.3%) compared with 19 (19.3%) in non-Hispanic Caucasians, <i>p</i> = 0.02), and had a larger HCC burden at diagnosis. We conclude that compared to white patients, despite having similar BMI and MELD scores and rates of portal vein thrombosis, AA patients with HCC in our cohort were older at presentation, had a significantly increased incidence of modifiable metabolic risk factors including diabetes, higher AFP values, increased incidence of gallstones, and larger sized HCCs, and were more likely to be outside Milan criteria. These findings have important prognostic and diagnostic implications for developing a more targeted HCC surveillance program.https://www.mdpi.com/1873-149X/28/3/26hepatocellular carcinomaethnicityraceoverall survivalsurvival disparity |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hrishikesh Samant Kapil Kohli Krunal Patel Runhua Shi Paul Jordan James Morris Annie Schwartz Jonathan Steven Alexander |
spellingShingle |
Hrishikesh Samant Kapil Kohli Krunal Patel Runhua Shi Paul Jordan James Morris Annie Schwartz Jonathan Steven Alexander Clinical Presentation of Hepatocellular Carcinoma in African Americans vs. Caucasians: A Retrospective Analysis Pathophysiology hepatocellular carcinoma ethnicity race overall survival survival disparity |
author_facet |
Hrishikesh Samant Kapil Kohli Krunal Patel Runhua Shi Paul Jordan James Morris Annie Schwartz Jonathan Steven Alexander |
author_sort |
Hrishikesh Samant |
title |
Clinical Presentation of Hepatocellular Carcinoma in African Americans vs. Caucasians: A Retrospective Analysis |
title_short |
Clinical Presentation of Hepatocellular Carcinoma in African Americans vs. Caucasians: A Retrospective Analysis |
title_full |
Clinical Presentation of Hepatocellular Carcinoma in African Americans vs. Caucasians: A Retrospective Analysis |
title_fullStr |
Clinical Presentation of Hepatocellular Carcinoma in African Americans vs. Caucasians: A Retrospective Analysis |
title_full_unstemmed |
Clinical Presentation of Hepatocellular Carcinoma in African Americans vs. Caucasians: A Retrospective Analysis |
title_sort |
clinical presentation of hepatocellular carcinoma in african americans vs. caucasians: a retrospective analysis |
publisher |
MDPI AG |
series |
Pathophysiology |
issn |
1873-149X |
publishDate |
2021-08-01 |
description |
Hepatocellular carcinoma (HCC) remains an important form of cancer-related morbidity and mortality in the U.S. and worldwide. Previous U.S.-based studies on survival suggest ethnic disparities in HCC patients, but the complex interplay of multiple factors that contribute are still incompletely understood. Here we considered the influences of risk factors contributing towards HCC survival, including ethnic background, over ten years at a premier academic medical center with a majority (57.20%) African American (AA) population. Retrospective HCC data were collected from 2008–2018 at LSUHSC-Shreveport, an urban tertiary medical center. Data included demographics, comorbidities, liver disease characteristics, and tumor parameters. Statistical analysis was performed using Chi Square and one-way ANOVA. Results: 229 HCC patients were identified (male 78.6%). The mean HCC age at diagnosis was 61 years (SD = 7.3). Compared to non-Hispanic Caucasians (42.7%), AA patients (57.2% of total) were older at presentation, had more frequent diabetes/dyslipidemia/NAFLD (45 (34.3%) compared with 19 (19.3%) in non-Hispanic Caucasians, <i>p</i> = 0.02), and had a larger HCC burden at diagnosis. We conclude that compared to white patients, despite having similar BMI and MELD scores and rates of portal vein thrombosis, AA patients with HCC in our cohort were older at presentation, had a significantly increased incidence of modifiable metabolic risk factors including diabetes, higher AFP values, increased incidence of gallstones, and larger sized HCCs, and were more likely to be outside Milan criteria. These findings have important prognostic and diagnostic implications for developing a more targeted HCC surveillance program. |
topic |
hepatocellular carcinoma ethnicity race overall survival survival disparity |
url |
https://www.mdpi.com/1873-149X/28/3/26 |
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