Socioeconomic Factors Impacting Survival in Patients With Hepatocellular Carcinoma Treated With Locoregional Therapies: A Single-Center Study.

PURPOSE: To evaluate the impact of socioeconomic factors on survival in patients with HCC undergoing interventional locoregional therapy (LRT) at a tertiary center.

MATERIALS AND

METHODS

This study comprised a retrospective cohort of 1,091 patients with HCC treated with interventional LRT (2000-2022). Clinical and socioeconomic data (gender, insurance, race, education, language, and marital status) were collected. Survival analysis used Kaplan-Meier and multivariable Cox regression to assess the impact of socioeconomic factors. Among identified patients (median age, 63 years; interquartile range [IQR], 12.14 years; 81% men), the majority had Medicare (43%) or private insurance (33%), were White (63%), had a college (42%) or high school (45%) education, and were married (51%). Median α-fetoprotein was 11 ng/mL (IQR, 76 ng/mL); most were with Child-Pugh B status (72%), Barcelona Clinic Liver Cancer Stage A (66%), and Eastern Cooperative Oncology Group performance status of 0 (75%). Overall mortality was 62%, and 23% underwent liver transplant.

RESULTS

Female gender (hazards ratio [HR], 1.26; 95% confidence interval [CI], 1.03-1.55; P = .028), lower education (high school vs. college; HR, 1.24; 95% CI, 1.04-1.50; P = .015), and being divorced (HR, 1.43; 95% CI, 1.08-1.90; P = .012) were independently associated with increased mortality. Asian race predicted improved survival (HR, 0.44; 95% CI, 0.29-0.67; P < .05).

CONCLUSIONS

Asian race, male gender, marriage, and higher education independently predicted better survival in patients with HCC receiving interventional LRT.