Differential characteristics and outcomes of Asian and non-Asian patients with HBV-related hepatocellular carcinoma
Daniel Q. Huang and Joseph K. Hoang should be considered joint first author.
Funding information
No external funding to disclose.
Handling Editor: Pierre Nahon
Abstract
Background & Aims
The epidemiology of hepatitis B virus (HBV) infection differs between Asians and non-Asians, but little is known regarding the effect of ethnicity on outcomes of HBV-related hepatocellular carcinoma (HCC). We aim to characterize the presentation and survival outcomes in Asian and non-Asian patients with HBV-related HCC.
Methods
We analyzed the baseline characteristics and long-term survival of 613 Asian and 410 non-Asian patients with HBV-related HCC from three US and one Spanish centre.
Results
Overall, non-Asian patients were more likely to have HIV or hepatitis C co-infection, cirrhosis, decompensated liver disease and advanced BCLC stage (all P ≤ .04). Compared with Asians, non-Asians were more likely to be listed for transplantation (P < .0001) and undergo HCC treatment with curative intent (P = .003). Propensity-score matching on HCC diagnosis year, gender and age was performed to balance the two groups for survival analysis and yielded 370 pairs of patients. There was no significant difference in survival overall (P = .43) and among patients with cirrhosis (P = .57). Among patients without cirrhosis, non-Asians had poorer 5-year survival compared with Asians (37.6% vs 53.7%, P = .01), and was associated with poorer survival after adjusting for age, gender, diabetes, alcohol, co-infections, diagnosis date, antiviral therapy, BCLC stage and HCC treatment (adjusted HR 2.01 [95% CI 1.07-3.74], P = .03).
Conclusion
Among HBV-related HCC patients, non-Asians presented with more advanced BCLC stage compared to Asians. Non-Asian ethnicity was independently associated with twice the risk of mortality among patients without cirrhosis, but not among those with cirrhosis. Additional studies are needed to clarify this disparity.
CONFLICT OF INTEREST
Mindie H. Nguyen: Research support: Pfizer, Enanta, Gilead, Glycotest, Vir Biotech, BK Kee Foundation, National Cancer Institute. Advisory board/consulting: Janssen, Spring Bank, Gilead, Novartis, Bayer, Eisai, Eli Lilly, Exact Sciences, Laboratory of Advanced Medicine, Helio Health, Intercept. Daniel Q. Huang: Research support: Exxon Mobil-NUS Research Fellowship for Clinicians, NMRC Research Training Fellowship. Advisory board/consulting: Eisai. Mar Riveiro-Barciela: Research support from Gilead. Speaker's fee from Grifols. Ramsey C. Cheung: Research support from Gilead. Lewis R. Roberts: Research support from Bayer, BTG International, Exact Sciences, Gilead Sciences, Glycotest Inc, RedHill BioPharma Inc, Target PharmaSolutions and Wako Diagnostics. Advisory Board/Consulting: AstraZeneca Pharmaceuticals LP, Bayer, Exact Sciences, Gilead Sciences, GRAIL Inc, QED Therapeutics and TAVEC. Maria Buti: Research support from Gilead. Advisory board/consulting: Abbvie, Janssen, Spring Bank, Gilead. Jennifer Leong: Research support from Gilead. Ju Dong Yang: Advisory board/consulting: Exact Sciences. Other authors have no disclosures.
Open Research
DATA AVAILABILITY STATEMENT
Data is available upon reasonable request.
