Abstract 4369: The effects of primary hepatocellular carcinoma surgical resection on five year survival rates among different races
Authors: Song Jingwei , Song Eric , Gharavi Daniel 
Published: April 2023

Abstract
Background: Hepatic surgical resection is the treatment of choice for noncirrhotic HCC patients. Previous studies indicate that Asian patients were proportionally more likely to be treated surgically. However, studies on the outcome of this preference are very limited.
Methods:We examined data from the Surveillance, Epidemiology and End Results (SEER)-Medicare database to identify patients diagnosed with HCC between 2004 and 2017.The disease specific and relative five year survival rates as well as 95% Cl were calculated.
Results:Among the total of 6,716 Asian or Pacific Islander (A/P) patients diagnosed with localized HCC, 45.9% of them received surgical resection. The localized HCC surgical resection rates for White (27,360 total cases) and Black (4,546 total cases) were 35.6% and 33.1% respectively. This pattern remained the same for patients with regional and distant site involved HCC: Highest percentage of A/P patients received surgical resections. For patients with localized HCC, five year cause specific survival rate was statistically higher for A/P patients than White and Black (P&lt;0.05) 24 months after the surgery. These trends continued until the end of the study. For patients with regional HCC, surgical resection played no significant role for the five year cause specific survival rate among the different races. However, for patients with distant involved HCC, five year cause specific survival gap between White and A/P gradually increased after surgery and reached a statistically significant level on month 48 (23.9% with 95% CI 18.6% to 29.6% for White and 9.7% with 95% CI 4.4% to 17.5% for A/P). The pattern remained the same between Black and A/P patients without statistical significance, most likely due to the limited sample size for both.. Our research also indicated that surgical resection may play a similar role for the five year relative survival rate. After localized HCC surgical resection, A/P patients had the highest five year relative survival rate compared to White and Black patients (P&lt;0.05). For the patients with regional HCC, surgical resection played no significant role on five year relative survival rate among different races. However, for the patients diagnosed with distant involved HCC, five year relative survival gap between White and A/P gradually increased after surgery and reached a statistically significant level on month 48 (23.7% with 95% CI 18.3% to 29.4% for White and 10.5% with 95% CI 5.2% to 18.0% for A/P). The pattern remained the same between Black and A/P patients without statistical significance due to the limited sample size in both categories.
Conclusion: A/P primary HCC patients were more likely to be treated surgically. However, the benefits of surgical resection for A/P patients can only be appreciated for those with localized HCC. For A/P patients diagnosed with distant site node involved HCC, surgical resection may cause more harm than good.
Citation Format: Jingwei Song, Eric Song, Daniel Gharavi. The effects of primary hepatocellular carcinoma surgical resection on five year survival rates among different races. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4369.