Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 28, 2017; 9(36): 1346-1351
Published online Dec 28, 2017. doi: 10.4254/wjh.v9.i36.1346
Women receive more inpatient resections and ablations for hepatocellular carcinoma than men
Lindsay Sobotka, Alice Hinton, Lanla Conteh
Lindsay Sobotka, Department of Internal Medicine, the Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Alice Hinton, Division of Biostatistics, College of Public Health, the Ohio State University, Columbus, OH 43210, United States
Lanla Conteh, Section of Hepatology, Division of Gastroenterology, Hepatology and Nutrition, the Hepatocellular Carcinoma Multidisciplinary Clinic, the James Comprehensive Cancer Center, the Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Author contributions: Sobotka L, Hinton A and Conteh L contributed equally to this work; Hinton A collected the data and performed statistical analysis; Sobotka L and Conteh L analyzed the data, drafted the manuscript and revised for important intellectual content; Conteh L supervised the study.
Institutional review board statement: The Ohio State University Data and Specimen Policy and Human Subjects Research Policy does not require Institutional Review Board approval for population-based public data sets. Per 45 Code of Federal Regulations (CFR 46.101), research using certain publicly available data sets does not involve “human subjects”.
Conflict-of-interest statement: All the authors have no conflicts of interest.
Data sharing statement: No additional data is available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lanla Conteh, MD, MPH, Director of Hepatology, Hepatobiliary Tumor Program, Director of Hepatology Outreach Program, Section of Hepatology, Division of Gastroenterology, Hepatology and Nutrition, the Hepatocellular Carcinoma Multidisciplinary Clinic, the James Comprehensive Cancer Center, the Ohio State University Wexner Medical Center, 410 W. 10th Street, Columbus, OH 43210, United States. lanla.conteh@osumc.edu
Telephone: +1-614-2931456 Fax: +1-614-2936720
Received: September 10, 2017
Peer-review started: September 22, 2017
First decision: November 3, 2017
Revised: November 14, 2017
Accepted: December 4, 2017
Article in press: December 5, 2017
Published online: December 28, 2017
Processing time: 107 Days and 12.2 Hours
Abstract
AIM

To evaluate disparities in the treatment of hepatocellular carcinoma (HCC) based on gender.

METHODS

A retrospective database analysis using the Nationwide Inpatient Sample (NIS) was performed between 2010 and 2013. Adult patients with a primary diagnosis of hepatocellular carcinoma determined by International Classification of Disease 9 (ICD-9) codes were included. Univariate analysis and multivariate logistic regressions were performed to analyze differences in treatment, mortality, features of decompensation, and metastatic disease based on the patient’s gender.

RESULTS

The analysis included 62582 patients with 45908 men and 16674 women. Women were less likely to present with decompensated liver disease (OR = 0.84, P < 0.001) and had less risk of inpatient mortality when compared to men (OR = 0.75, P < 0.001). Women were more likely to receive inpatient resection (OR = 1.31, P < 0.001) or an ablation (OR = 1.22, P = 0.028) than men. There was no significant difference between men and women in regard to liver transplantation and transcatheter arterial chemoembolization (TACE).

CONCLUSION

Gender impacts treatment for hepatocellular carcinoma. Women are more likely to undergo an ablation or resection then men. Gender disparities in transplantation have resolved.

Keywords: Hepatocellular carcinoma; Gender disparities; Liver transplantation; Liver resection; Ablation

Core tip: Previous studies have evaluated treatment disparities in the treatment of hepatocellular carcinoma (HCC) based on gender. Despite recent emphasis to ensure equal care for all patients this study continues to show disparities in the treatment of HCC, specifically in resection and ablation. Gender disparities in the treatment of HCC with transplantation have resolved.