Background: Previous studies have shown conflicting data regarding gender disparities in the treatment of hepatocellular carcinoma. Several studies have suggested that men are more likely to receive a liver transplant and women more likely to undergo hepatic resection.

Aims: The aim of this study is to use the Nationwide Inpatient Sample to assess gender differences in the treatment of hepatocellular carcinoma.

Methods: A retrospective database analysis on the Nationwide Inpatient Sample (NIS) database was performed from 2010 to 2013. Adults 18 and older with a primary diagnosis of hepatocellular carcinoma represented by an International Classification of Diseases 9^th Edition (ICD-9) code were included. Univariate analysis and multivariate logistic regressions were performed to examine differences in HCC treatment stratified by gender.

Results: The analysis included 62,582 patients from the NIS database with a total of 45,908 men and 16,674 women. Based on univariate analysis, the majority of the patients, regardless of gender, were Caucasian, under the age of 64, and had Medicare as the primary payer for their care. Further analysis of the patient population stratified by gender revealed that women were less likely to present with decompensated liver disease than men (OR 0.84, p value <0.001). Women also had significantly less risk of inpatient mortality when compared to men (OR 0.75, p value <0.001). There was no statistical difference between gender in developing metastatic hepatocellular carcinoma. In regards to treatment, women were more likely to receive a resection (OR 1.31, p value <0.001) or an ablation (OR 1.22, p value 0.028) than men. There was no statistically significant difference between men and women in regards to liver transplantation and transcatheter arterial chemoembolization.

Conclusion: Gender disparities still exist in the treatment of hepatocellular carcinoma. Women in the United States who are hospitalized with hepatocellular carcinoma continue to receive more resections than men. This study shows that women are also more likely to receive an ablation than men. Though previous studies have shown that men are more likely to receive liver transplant than women, this study does not show any difference in transplantation rates between genders.

CITATION INFORMATION: Sobotka L, Hinton A, Conteh L. Women in the United States Receive More Resections and Ablations for Hepatocellular Carcinoma Than Men. Am J Transplant. 2017;17 (suppl 3).

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