Decision to operate on hepatocellular cancer patients is not driven by comorbidities in Louisiana

Document Type

Article

Publication Date

5-27-2025

Publication Title

HPB

Abstract

Background The mortality rate of Hepatocellular cancer (HCC) in Louisiana is second worst in the United States. This has been linked to underutilization of curative treatment (CT). This study aimed to identify risk factors associated with underutilization of CT in Louisiana. Methods Patients with AJCC T1 HCC diagnosed from 2011 to 2020 were identified from the Louisiana Tumor Registry (LTR) using site and histology codes. Patients who underwent CT (ablation, resection, and transplantation) were compared to those who did not undergo CT. Logistic regression was performed and results reported as adjusted odds ratios. Results CT was utilized in 462 (37 %) of 1247 patients with T1 HCC. There were no significant differences observed in age, race, BMI, poverty, or rurality between CT and non-CT patients. The percentage of cirrhosis was similar in both groups (35.3 % vs. 37.7 %, NS). On multivariant analysis, lack of CT was independently associated with low socioeconomic status (SES; p = 0.040), treatment outside a COC center (p < 0.001), and lack commercial/private insurance (p < 0.001). Conclusion Utilization of CT is driven not by comorbidities, but by insurance type, low SES, and treatment facility indicating the profound effect that care disparities have on HCC treatment.

First Page

679

Last Page

687

DOI

10.1016/j.hpb.2025.01.013

Rights

© 2025 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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