Black patients with colorectal liver metastases (CRLM) in California were less likely to seek treatment and had poorer survival rates compared with other ethnic groups. These findings, from a retrospective cohort study, were published in JAMA Network Open.

The California Cancer Registry was queried by researchers from the City of Hope National Medical Center for patients with synchronous CRLM between 2000 and 2012 (N=16,382).

Among all patient groups, Black patients had the shortest median survival (11 months) and people from the Middle East had the longest (18 months). Patients who were White (12 months), Asian (14 months), or Hispanic (14 months) had intermediate median survival durations.

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Compared with other patient groups, Black patients were less likely to receive chemotherapy (59% vs 65% [White] or 68% [Hispanic]; P <.001) or to undergo liver resection (6.2% vs 10.3% [White] or 9.5% [Hispanic]; P <.001).

The overall mortality risk for Black patients was 17% higher (hazard ratio [HR], 1.17; 95% CI, 1.10-1.24; P <.001) compared with White patients, after correcting for potential cofactors. However, among the patients who underwent liver resection, no difference of survival was observed (HR, 1.01; 95% CI, 0.94-1.08; P =.84).

This study was limited by the fact that investigators were unable to account for resectability of liver metastases, which may depend on some genetic feature, thereby associating with ethnicity.

The study authors concluded that significantly fewer Black Americans sought treatment for CRLM and had poorer clinical outcomes. These data reinforced the need for addressing disparities of quality and access to medical care for all Americans.

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Thornblade L W, Warner S, Melstrom L, Singh G, Fong Y, Raoof M. Association of race/ethnicity with overall survival among patients with colorectal liver metastasis. JAMA Netw Open. 2020;3(9):e2016019. doi:10.1001/jamanetworkopen.2020.16019.