Omar Abdel-Rahman1. 1. Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, AB, T6G 1Z2, Canada. omar.abdelsalam@ahs.ca.
Abstract
OBJECTIVE: To assess the impact of socioeconomic status (SES) on treatment choices and outcomes of hepatocellular carcinoma (HCC) patients treated with local therapies (ablation or surgery). METHODS: Surveillance, Epidemiology and End Results (SEER) specialized socioeconomic database was accessed. Cases with non-metastatic HCC treated with ablation or surgery between 2000 and 2015 were included. Socioeconomic index stratified patients into three groups (1-3) where group-1 has the lowest SES and group-3 has the highest SES. Impact of SES on the choice of local treatment was assessed in a multivariate logistic regression model. Likewise, the impact of SES on liver cancer-specific survival was assessed in a multivariate Cox regression model. Competing risk analysis for the impact of SES on liver cancer mortality was additionally conducted. RESULTS: A total of 14,333 non-metastatic HCC patients were included in the final analysis. In a multivariable logistic regression analysis, SES did not predict the type of local treatment (ablation versus surgical treatment) (adjusted odds ratio for group 1 versus group 3: 0.931; 95% CI 0.854-1.015; P = 0.10). On the other hand, and in a multivariable Cox regression analysis, lower socioeconomic status was associated with worse liver cancer-specific survival (adjusted hazard ratio for group-1 versus group-3: 6.448; 95% CI 5.696-7.298; P < 0.01). Likewise, and in competing risk analysis, lower socioeconomic group was associated with worse liver cancer-specific survival (adjusted sub-distribution hazard ratio for group-1 versus group-3: 1.102; 95% CI 1.016-1.196; P = 0.019). CONCLUSIONS: Lower SES is associated with worse liver cancer-specific survival among non-metastatic HCC patients treated with ablation or surgery.
OBJECTIVE: To assess the impact of socioeconomic status (SES) on treatment choices and outcomes of hepatocellular carcinoma (HCC) patients treated with local therapies (ablation or surgery). METHODS: Surveillance, Epidemiology and End Results (SEER) specialized socioeconomic database was accessed. Cases with non-metastatic HCC treated with ablation or surgery between 2000 and 2015 were included. Socioeconomic index stratified patients into three groups (1-3) where group-1 has the lowest SES and group-3 has the highest SES. Impact of SES on the choice of local treatment was assessed in a multivariate logistic regression model. Likewise, the impact of SES on liver cancer-specific survival was assessed in a multivariate Cox regression model. Competing risk analysis for the impact of SES on liver cancer mortality was additionally conducted. RESULTS: A total of 14,333 non-metastatic HCCpatients were included in the final analysis. In a multivariable logistic regression analysis, SES did not predict the type of local treatment (ablation versus surgical treatment) (adjusted odds ratio for group 1 versus group 3: 0.931; 95% CI 0.854-1.015; P = 0.10). On the other hand, and in a multivariable Cox regression analysis, lower socioeconomic status was associated with worse liver cancer-specific survival (adjusted hazard ratio for group-1 versus group-3: 6.448; 95% CI 5.696-7.298; P < 0.01). Likewise, and in competing risk analysis, lower socioeconomic group was associated with worse liver cancer-specific survival (adjusted sub-distribution hazard ratio for group-1 versus group-3: 1.102; 95% CI 1.016-1.196; P = 0.019). CONCLUSIONS: Lower SES is associated with worse liver cancer-specific survival among non-metastatic HCCpatients treated with ablation or surgery.