Epidemiology

Liver transplantation for hepatocellular cancer in whites, Asians nearing parity

Last Updated: 2008-11-07 15:13:19 -0400 (Reuters Health)

NEW YORK (Reuters Health) - In recent years, the disparity in liver transplantation rates for hepatocellular carcinoma (HCC) favoring whites over Asians has decreased to near parity, at least in California, according to a report in the October 15th issue of Cancer.

Dr. Anthony S. Robbins from the California Cancer Registry, Sacramento, and colleagues examined whether differences in liver transplantation rates between whites and Asian/Pacific Islanders (APIs) with HCC were changing over time.

A preliminary study in 2002 showed that whites were 1.5 times more likely than APIs to undergo liver transplantation in the prior 4 years, the authors explain.

During the current study period running from 1998 to 2005, they found that transplantation rates were higher for whites (19.8%) than for APIs (14.1%).

The odds of undergoing transplantation were 2.56 times higher for whites than for APIs between 1998 and 2003, the researchers note, but in the last 2 years studied, there were no significant racial differences in the odds of transplantation.

Five-year survival rates were higher for patients who underwent liver transplantation (68.2%) than for those who did not (23.4%).

In 2002, the investigators say, the Unified Network for Organ Sharing (UNOS) started assigning additional Model of End-stage Liver Disease (MELD) points to patients with HCC awaiting liver transplantation. "Our analyses may be among the first to document the particularly favorable outcomes observed among APIs after the implementation of these policy changes," they write.

"The UNOS policy changes have provided a rational means for increasing liver transplantations among groups with historically lower use of this life-saving treatment," the authors conclude.

Cancer 2008;113:2173-2179.