The following is a summary of “Healthcare Disparities in Access to Surgical Management and Outcomes of Patients with Nonmetastatic Primary Liver Cancer: A Population Based Study from Louisiana Tumor Registry,” published in the October 2024 issue of Surgery by Hargis et al.
Factors contributing to disparities in access to surgical interventions for patients with primary nonmetastatic liver cancer are complex and multifaceted.
Researchers conducted a retrospective study to determine the factors associated with disparities in the receipt and outcomes of surgical interventions for patients with primary nonmetastatic liver cancers.
They utilized cases from the Louisiana Tumor Registry (2010-2020) and categorized surgical interventions into 4 groups, none, ablation, resection, and transplant. The bivariate relationships were assessed using Chi-square tests, and overall survival (OS) was visualized with Kaplan-Meier plots. Results were compared via log-rank tests, and data was analyzed using Cox proportional hazards models.
The results showed 24.5% of patients underwent surgical interventions. Black patients had significantly lower odds of receiving transplants and experienced decreased OS following the transplant. Uninsured individuals, those on Medicaid, and patients living in rural areas had reduced odds of undergoing surgical treatment. Additionally, older age and the absence of a domestic partner decreased the likelihood of receiving a transplant. Factors like older age, male sex, no domestic partner, and rural residence were associated with decreased OS after transplant.
They concluded that identifying at-risk populations and allocating resources effectively was crucial for improving access to surgical interventions and enhancing outcomes for patients with primary nonmetastatic liver cancer.
Source: americanjournalofsurgery.com/article/S0002-9610(24)00591-9/abstract
