Material deprivation affects the management and clinical outcome of hepatocellular carcinoma in a high-resource environment

Cucchetti, Alessandro, Gramenzi, Annagiulia, Johnson, Philip ORCID: 0000-0003-1404-0209, Giannini, Edoardo G, Tovoli, Francesco, Rapaccini, Gian Ludovico, Marra, Fabio, Cabibbo, Giuseppe, Caturelli, Eugenio, Gasbarrini, Antonio
et al (show 86 more authors) (2021) Material deprivation affects the management and clinical outcome of hepatocellular carcinoma in a high-resource environment. European Journal of Cancer, 158. pp. 133-143.

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<h4>Aim</h4>This study investigated how material deprivation in Italy influences the stage of hepatocellular carcinoma (HCC) at diagnosis and the chance of cure.<h4>Methods</h4>4114 patients from the Italian Liver Cancer database consecutively diagnosed with HCC between January 2008 and December 2018 were analysed about severe material deprivation (SMD) rate tertiles of the region of birth and region of managing hospitals, according to the European Statistics on Income and Living Conditions. The main outcomes were HCC diagnosis modalities (during or outside surveillance), treatment adoption and overall survival.<h4>Results</h4>In more deprived regions, HCC was more frequently diagnosed during surveillance, while the incidental diagnosis was prevalent in the least deprived. Tumour characteristics did not differ among regions. The proportion of patients undergoing potentially curative treatments progressively decreased as the SMD worsened. Consequently, overall survival was better in less deprived regions. Patients who moved from most deprived to less deprived regions increased their probability of receiving potentially curative treatments by 1.11 times (95% CI 1.03 to 1.19), decreasing their mortality likelihood (hazard ratio 0.78 95% CI 0.67 to 0.90).<h4>Conclusions</h4>Socioeconomic status measured through SMD does not seem to influence HCC features at diagnosis but brings a negative effect on the chance of receiving potentially curative treatments. Patient mobility from the most deprived to the less deprived regions increased the access to curative therapies, with the ultimate result of improving survival.

Item Type: Article
Uncontrolled Keywords: Hepatocellular carcinoma, Deprivation, Prognosis, Overall survival, Social determinants of health
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 27 Oct 2021 13:00
Last Modified: 15 Mar 2023 12:19
DOI: 10.1016/j.ejca.2021.09.018
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