Sobotka L, Hinton A, Conteh L. Women receive more inpatient resections and ablations for hepatocellular carcinoma than men. World J Hepatol 2017; 9(36): 1346-1351 [PMID: 29359018 DOI: 10.4254/wjh.v9.i36.1346]
Corresponding Author of This Article
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
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
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Sobotka L, Hinton A, Conteh L. Women receive more inpatient resections and ablations for hepatocellular carcinoma than men. World J Hepatol 2017; 9(36): 1346-1351 [PMID: 29359018 DOI: 10.4254/wjh.v9.i36.1346]
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.
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.
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.
