title: Clinical presentation of hepatocellular carcinoma (HCC) in Asian-Americans versus non-Asian-Americans.
abstract: The incidence of HCC is rising worldwide. Studies on ethnicity-based clinical presentation of HCC remain limited. The aim is to compare the clinical presentation and stage of HCC between Asian-Americans and non-Asian-Americans. This retrospective study assessed ethnicity-based differences in HCC presentation, including demographics, laboratory results, diagnosis of underlying liver disease, and stage of HCC. Of 276 patients, 162 were Asian-Americans and 114 were non-Asian-Americans. Compared to non-Asian-Americans, Asian-Americans had a significantly higher incidence of history of hepatitis B virus (HBV) infection (55.0% vs. 4.9%, P < 0.001), family history of HBV infection (12.5% vs. 0.0%, P < 0.001) and HCC (15.2% vs. 2.9%, P = 0.002), but lower incidence of history of hepatitis C virus (HCV) infection (37.5% vs. 61.6%, P < 0.001). At diagnosis of HCC, Asian-American patients had a significantly lower frequency of hepatic encephalopathy (8.9% vs. 29.3%, P = 0.001), and ascites (26.7% vs. 57.3%, P < 0.001). Asian-Americans had lower Child-Pugh scores (class A: 62.0% vs. 31.4%, P < 0.001), and MELD scores (9.2 ± 4.4 vs. 12.0 ± 6.4, P = 0.02), and presented with a lower stage of HCC by Okuda staging (I: 43.8% vs. 22.8%, P = 0.001). Asian-American patients with HCC presented with a higher incidence of history and family history of HBV infection, lower incidence of hepatic decompensation, lower Child and MELD scores, and an early stage HCC disease.
authors.affiliation: Department of Internal Medicine, University of California Irvine School of Medicine, Irvine, CA, USA.
authors.forename: Philip Y
authors.initials: PY
authors.lastname: Wong
authors.forename: Victor
authors.initials: V
authors.lastname: Xia
authors.forename: David K
authors.initials: DK
authors.lastname: Imagawa
authors.forename: John
authors.initials: J
authors.lastname: Hoefs
authors.forename: Ke-Qin
authors.initials: KQ
authors.lastname: Hu
mesh_terms: D000368:Aged; D001213:Asian; D002140:California; D006528:Carcinoma, Hepatocellular / Q000208:ethnology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000208:ethnology* / Q000503:physiopathology*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged