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Racial Disparities in Liver Transplant for Hepatitis C-Associated Hepatocellular Carcinoma.

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Racial Disparities in Liver Transplant for Hepatitis C-Associated Hepatocellular Carcinoma. Annals of surgical oncology Bennett, F. J., Keilson, J. M., Turgeon, M. K., Oppat, K. M., Warren, E. A., Shah, S. A., Agopian, V. G., Magliocca, J. F., Cameron, A., Orloff, S. L., Kubal, C. A., Cannon, R. M., Akoad, M. E., Emamaullee, J., Aucejo, F., Vagefi, P. A., Nguyen, M. H., Dhanireddy, K., Kazimi, M. M., Sonnenday, C. J., Foley, D. P., Abdouljoud, M., Sudan, D. L., Humar, A., Doyle, M. B., Chapman, W. C., Maithel, S. K. 2024

Abstract

In the United States, hepatitis C virus-associated hepatocellular carcinoma incidence and mortality are highest among minorities. Socioeconomic constraints play a major role in inequitable treatment. We evaluated the association between race/ethnicity and outcomes in a population that overcame treatment barriers.We report a retrospective cohort study of 666 patients across 20 institutions in the United States Hepatocellular Carcinoma Liver Transplantation Consortium from 2015 to 2019 with hepatitis C virus-associated hepatocellular carcinoma who completed direct-acting antiviral therapy and underwent liver transplantation. Patients were excluded if they had a prior liver transplantation, hepatocellular carcinoma recurrence, no prior liver-directed therapy, or if race/ethnicity data were unavailable. Patients were stratified by race/ethnicity. Primary outcomes were recurrence-free survival and overall survival, and secondary outcome was major postoperative complication.Race/ethnicity was not associated with differences in 5-year recurrence-free survival (White 90%, Black 88%, Hispanic 92%, Other 87%; p = 0.85), overall survival (White 85%, Black 84%, Hispanic 84%, Other 93%; p = 0.70), or major postoperative complication.Race/ethnicity was not associated with worse oncologic or postoperative outcomes among those who completed direct-acting antiviral therapy and underwent liver transplantation, suggesting that overcoming socioeconomic constraints equalizes outcomes across racial/ethnic groups. Eliminating barriers that prohibit care access among minorities must be a priority.

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