Minzhi Xing MD, Presenter: Nothing to Disclose

Nima Kokabi MD, Abstract Co-Author: Nothing to Disclose

Richard Duszak MD, Abstract Co-Author: Nothing to Disclose

Kimberly E. Applegate MD, MS, Abstract Co-Author: Co-editor, Springer Science+Business Media Deutschland GmbH Advisory Board, WellPoint, Inc

Juan Camilo Camacho, Abstract Co-Author: Nothing to Disclose

Hyun Sik Kim MD, Abstract Co-Author: Nothing to Disclose

To investigate long-term survival in patients with chemorefractory, unresectable hepatocellular carcinoma (HCC) based on demographics and socio-economic factors in a large-scale population study.

Eighteen registries of the U.S. Surveillance, Epidemiology and End Results (SEER) database were queried for patients with HCC not amenable to cancer-directed surgery/radiation diagnosed between 2000 and 2010. Mean overall survival was stratified according to patient characteristics including gender, age at diagnosis, ethnicity, geographic location, income level, education, and urbanization. Survival analysis and 95% confidence intervals (CI) were calculated using Kaplan-Meier estimation and compared using the log-rank test. Multivariate Cox proportional hazard models were used to assess independent prognostic factors for overall survival.

Of 63,434 newly diagnosed primary liver cancer patients in the US between 2000 and 2010, 52,944 patients had HCC. The median age of all HCC patients was 63 years, 74% (39,201) male. Overall survival was significantly correlated with age at diagnosis (<70 vs. ≥70 years, 8.9 vs. 6.9 months), ethnicity (white, black, American Indian, Asian/Pacific Islander; 7.9, 7.1, 8.3, 10.5 months, respectively), geographic location (East, Northern Plains, Southwest, Pacific Coast, Alaska; 7.6, 6.4, 7.1, 8.6, 7.6 months, respectively), income level (median household income ≥$45k vs. <$45k/year, 6.8 vs. 8.5 months), education (% with bachelor degree or above, ≥15% vs. <15%, 6.6 vs. 8.4 months), and degree of urbanization (county population ≥50,000 vs. <50,000, 8.4 vs. 6.6 months), p<0.001 for all.

Socio-demographic factors including age <70 years, Asian/Pacific Islanders, those from the Pacific coast, urban settings, higher income and education level were significantly correlated with prolonged survival in a large-scale population-based study.

The differences in survival in patients with HCC not amenable to cancer-directed surgery/radiation may be due to disparity in access to effective palliative therapy based on patient demographics and socio-economic factors

Xing, M, Kokabi, N, Duszak, R, Applegate, K, Camacho, J, Kim, H, The Effect of Demographics and Socio-Economic Factors on Survival in Unresectable Hepatocellular Carcinoma: a Surveillance, Epidemiology and End Results (SEER) Population Study.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016889.html