种族和民族差异对肝癌患者肝移植和肝移植后生存的影响。
Racial and Ethnic Differences in Liver Transplantation and Post-Liver Transplant Survival Among Patients With Hepatocellular Carcinoma.
机构信息
University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA.
出版信息
Cancer Med. 2024 Nov;13(21):e70298. doi: 10.1002/cam4.70298.
BACKGROUND
Racial and ethnic disparities in diagnosis and overall outcomes for HCC are well known. We present updated real-world data on racial or ethnic differences in LT and post-LT survival among patients with HCC in a large population-based database.
METHODS
We used the TriNetX database to retrospectively identify patients who had HCC (ICD-10 C22.0, C22.8) and underwent LT (CPT codes 47,135, 47,140, 47,140, 47,141, 47,142) from 2012 to 2022 and compared outcomes across racial and ethnic subgroups.
RESULTS
Majority of the patients were Caucasians (2403/2901, 84.8%), followed by African Americans (267/2901, 9.2%) Hispanic/Asian (231/2901, 7.9%). At follow up of 5 years, we noted no significant difference in mortality between AA and Caucasian patients [HR = 1.087 (95% CI 0.76, 1.56, p = 0.59)] as well as Hispanic/Asian and Caucasian patients [HR = 1.14 (95% CI 0.73, 1.78, p = 0.10)].
CONCLUSIONS
These results indicate that stringent implementation of policies aimed at ensuring equitable access to LT may contribute to bridging disparities in overall outcomes in HCC.
背景
种族和民族差异在 HCC 的诊断和整体结果中是众所周知的。我们在一个大型基于人群的数据库中展示了关于 HCC 患者在 LT 和 LT 后生存方面种族或民族差异的最新真实世界数据。
方法
我们使用 TriNetX 数据库回顾性地确定了 2012 年至 2022 年间患有 HCC（ICD-10 C22.0、C22.8）并接受 LT（CPT 代码 47,135、47,140、47,140、47,141、47,142）的患者，并比较了不同种族和族裔亚组的结果。
结果
大多数患者为白种人（2403/2901，84.8%），其次是非裔美国人（267/2901，9.2%）、西班牙裔/亚洲人（231/2901，7.9%）。在 5 年的随访中，我们发现非裔美国人和白种人患者之间的死亡率没有显著差异[HR=1.087（95% CI 0.76，1.56，p=0.59）]，西班牙裔/亚洲人和白种人患者之间的死亡率也没有显著差异[HR=1.14（95% CI 0.73，1.78，p=0.10）]。
结论
这些结果表明，严格执行旨在确保公平获得 LT 的政策，可能有助于缩小 HCC 整体结果方面的差异。
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