Racial Disparities in Hepatocellular Carcinoma Recurrence After Liver Transplant in US: A Real-World Data Study

Speaker(s)

Verma V1, Gaur A2, Sharma S2, Sachdev A2, Roy A2, Nayyar A2, Daral S2, Kukreja I2, Brooks L2, Khan S1
1Optum, Gurgaon, HR, India, 2Optum, Gurugram, HR, India

Presentation Documents

OBJECTIVES: This study aimed to assess racial disparities in Hepatocellular Carcinoma (HCC) recurrence after liver transplant and investigate the impact of alpha-fetoprotein (AFP) levels on recurrence rates.

METHODS: We conducted a retrospective study using the Optum® de-identified Market Clarity Dataset, focusing on HCC patients aged 40 years or older with continuous eligibility between January 1, 2011, and December 31, 2022. Patients who underwent liver transplant were identified between January 1, 2012, and December 31, 2019, and followed up for 36 months from index date of liver transplant to examine racial disparities in HCC recurrence and healthcare resource utilization (HRU). Further we will use Cox Proportional-Hazards method for recurrence analysis.

RESULTS: The study included 2,377 HCC patients with liver transplant, with an average age of 61. During the 36-month follow-up period, 1,542 patients experienced HCC recurrence. African American and Hispanic patients had earlier HCC recurrence compared to Caucasian patients, with mean days of 311, 310, and 323, respectively. A higher proportion of African American patients developed HCC recurrence, although the difference was not statistically significant (p=0.087). Significant differences were observed in HRU visits, with Caucasian patients having fewer ER visits compared to Hispanic patients (mean visits: 1.23 vs. 2.03, p=0.0058).

Furthermore, 1,179 patients were divided into three risk groups based on AFP levels in the baseline period: low(<10ng/ml), medium(10-400ng/ml), and high(>400ng/ml). The high and medium-risk groups experienced HCC recurrence earlier (8-10 months) compared to the low group (1 year) during the follow-up, with a significant difference (p<0.0001). Significant differences were also observed in the time to HCC recurrence among African American, Hispanic, and Caucasian patients (mean days: 223, 238, and 270, respectively).

CONCLUSIONS: Overall, this study sheds light on the importance of considering racial disparities and AFP levels in understanding HCC recurrence after liver transplant, providing valuable insights for risk stratification and patient care.

Code

RWD31

Topic

Clinical Outcomes, Health Policy & Regulatory, Study Approaches

Topic Subcategory

Clinical Outcomes Assessment, Electronic Medical & Health Records, Health Disparities & Equity

Disease

Oncology