Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2021; 9(23): 6734-6746
Published online Aug 16, 2021. doi: 10.12998/wjcc.v9.i23.6734
Increased morbidity and mortality of hepatocellular carcinoma patients in lower cost of living areas
Tomoki Sempokuya, Kishan P Patel, Muaataz Azawi, Jihyun Ma, Linda L Wong
Tomoki Sempokuya, Muaataz Azawi, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
Kishan P Patel, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, United States
Jihyun Ma, Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE 68198, United States
Linda L Wong, Department of Surgery, John A Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI 96817, United States
Author contributions: Sempokuya T contributed to the study design, data collection, and statistical analysis; Sempokuya T, Patel KP, and Azawi M contributed to the literature review, manuscript drafting, and editing; Ma J contributed to the study design and statistical analysis; Wong LL contributed to study supervision, manuscript drafting and editing; and all of the authors have approved the final version of the manuscript.
Institutional review board statement: Due to utilization of a publicly available, de-identified database, review by our institutional review board was not required.
Informed consent statement: Informed consent was not required to conduct this study.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Data sharing statement: All of the data used in this analysis is available from the SEER database.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Tomoki Sempokuya, MD, Doctor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Nebraska Medical Center, 982000 Nebraska Medical Center, Omaha, NE 68198, United States. tsempoku@hawaii.edu
Received: March 15, 2021
Peer-review started: March 15, 2021
First decision: April 6, 2021
Revised: April 11, 2021
Accepted: June 25, 2021
Article in press: June 25, 2021
Published online: August 16, 2021
Processing time: 143 Days and 10.5 Hours
Core Tip

Core Tip: This was a retrospective study to evaluate the relationship between the cost of living index (COLI) of patients with hepatocellular carcinoma (HCC) and treatment options, tumor characteristics, and median overall survival. Patients from lower COLIs were more likely to be uninsured (5.7% vs 3.4%), had more stage IV disease (15.2% vs 13%), and required more liver transplants (6.6% vs 4.4%) compared with those having the highest COLI. Median survival individuals with HCC from the highest COLI areas was significantly longer compared with the lowest COLI (14 mo vs 8 mo), suggesting that socioeconomic and racial disparities may contribute to survival for HCC.