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Disparities in Time to Treatment of Hepatocellular Carcinoma in Patients with Hepatitis B Virus versus Hepatitis C Virus

Jennifer Wu, Tsivia Hochman, Judith D Goldberg, Jafar Al-Mondhiry, Bennal Perkins, Iulia Giouriu and Lawrence Leichman

Background: The most common risk factors for hepatocellular carcinoma (HCC) are hepatitis B (HBV) and C (HCV). Patients with HCV related HCC have biology and outcomes distinct from HBV related HCC. We evaluated whether there is a difference in time from diagnosis to treatment between HCC patients with HBV and HCV.

Methods: We conducted a retrospective chart review to identify patients with confirmed HCC, and a known diagnosis of either HBV or HCV at Bellevue Hospital Center between January 2005 and December 2009. Medical records were reviewed for disease and treatment characteristics.

Results: Seventy HBV patients and 76 HCV patients were identified. HBV patients were mostly Asian (87%), while the majority of HCV patients were Black and Hispanic (28% and 47%, p<0.0001). At diagnosis, the HBV group presented with larger tumors compared to the HCV group (median 5.3 cm vs. 3.1 cm, p=0.025), and HCV patients were older than HBV patients (median age 61.3 years vs. 50.7 years, p<0.0001). Patients with HBV related HCC received treatment quicker than their HCV counterparts (median 2.1 vs. 3.2 months, p=0.019).

Conclusion: Patients with HCV related HCC wait longer for treatment when compared to patients with HBV related HCC in an urban inner-city hospital Efforts to reduce time between outside referral to oncology services may help decrease such disparity.