Racial disparities in mortality and length of hospital stay following palliative transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC): Insights from the 2021 National Inpatient Sample (NIS).

Abstract

e16263 Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, and Transarterial Chemoembolization (TACE) is a common palliative treatment for patients with intermediate-stage disease. Despite advancements in treatment, racial disparities in clinical outcomes following TACE remain underexplored. This study leverages the 2021 National Inpatient Sample (NIS) to investigate the impact of race on in-hospital mortality and length of hospital stay (LOS) after palliative TACE. Methods: This retrospective cohort study analyzed adult patients who underwent palliative TACE for HCC using the 2021 NIS. Racial groups included Caucasian, African American, Hispanic, and Asian patients. Outcomes assessed were in-hospital mortality and LOS, with multivariable logistic regression used to control for age, sex, income, and insurance type. Results: Among the 235 patients analyzed, the racial distribution was as follows: 60.9% Caucasian, 15.2% African American, 17.4% Hispanic, and 6.5% Asian. The median age was 67 years (IQR 63.8-69.5), and 59.6% were male. Key findings include: In-hospital Mortality: Only 2.13% of patients (5 patients) died during the procedure, making mortality rates too low for meaningful subgroup analysis. Length of Hospital Stay (LOS): The overall mean LOS was 5.6 days. However, multiracial individuals had a significantly longer stay compared to Caucasians, with Hispanic (OR -4.6, 95% CI -9.0 to -0.19, p = 0.04) and Asian patients (OR -3.4, 95% CI -6.4 to -0.42, p = 0.03) experiencing shorter stays. Hepatic Failure: 2.41% of patients experienced hepatic failure, but the small sample size limited the ability to assess disparities in this outcome. Conclusions: This analysis reveals notable racial disparities in the palliative use of TACE for HCC. Hispanic and Asian patients had shorter hospital stays compared to Caucasians, though these findings are subject to further exploration. Future studies should investigate contributing factors such as comorbidities, genetic predispositions, and hospital-level variables to better understand and address disparities in HCC care.