Research

The USC Registry of Patients with Hepatocellular Carcinoma

If you are a patient with hepatocellular carcinoma and are receiving care at a USC-affiliated medical care facility, you are eligible to participate in the USC Registry of Patients with Hepatocellular Carcinoma. USC-affiliated medical care facilities include:

• LAC+USC Medical Center and associated Roybal Liver Clinic, Hepatitis Clinic, Medical Oncology and Surgery Oncology Clinics and Liver Failure Clinic
• USC Norris Hospital and associated USC Internal Medicine, Inc. clinics
• USC Internal Medicine, Inc. outpatient hepatology practice located in the AHC
• USC University Hospital
• USC Department of Surgery outpatient practice located in the Healthcare Consultation Center
• Hepatitis Research and Treatment Center

All patient studies performed at the USC/Norris Liver Cancer Center are extremely important to the care of all patients, now and in the future. Please call us at (323) 442-5908 if you are interested in participating.

Background

Clinical care of patients with hepatocellular carcinoma (HCC) is complex and requires integrated expertise in hepatology, oncology, radiology, and surgery (including transplantation). These disciplines have advanced at USC considerably over the past ten years.

Organization of the multidisciplinary approach to the management of HCC has been markedly facilitated by the creation of the HCC Tumor Board, under the leadership of Dr. Kahn. The first meeting was held in December, 2002 and 10-15 new patients are now being presented at the bi-monthly meetings. This mechanism is aimed at developing a consensus for optimal treatment of patients, and the minutes of these meetings provide an accurate listing of such patients. However, patients who are initially evaluated as inpatients with such advanced disease that they are best managed with comfort measures, and inpatients who are discharged and do not return for follow-up are not currently being captured by this mechanism.

In 2001, Dr. Adrian DiBisceglie at Saint Louis University initiated "A National Registry of Patients with Hepatocellular Carcinoma." As of August 2003, six centers had enrolled 107 patients with HCC, 94% of whom had underlying chronic liver disease, with hepatitis C diagnosed in more than half of the patients. Forty-eight percent of patients were asymptomatic at presentation. Demographic analysis of the group showed that 75% were male, and 73% were non-Hispanic whites.

The patient population at LAC+USC Medical Center contrasts sharply with centers participating in the national registry. In a review of patients with hepatitis C at LAC+USC Medical Center, we found that 51% of patients were Latino, 12% were African American, and 6% were Asians. In order to determine which languages should be used for the Informed Consent document for this study, we reviewed the card file of patients seen b us on the Liver Consult Service over the last six months, a file maintained to provide continuity of care from the inpatient to the outpatient setting. Of the patients diagnosed with or having a high likelihood of HCC, 53% were Hispanic and 27% were Asian. Creation of a USC patient database to evaluate potential language, medical care access, and socioeconomic factors which may create barriers to care will allow a rational approach to intervention studies to be conducted at USC in the future.