Effect of the HCC Liver-Link Intervention
This study is a pilot, multi-center randomized controlled trial testing the HCC Liver-Link intervention, a culturally tailored, multi-level program designed to reduce racial disparities in hepatocellular carcinoma (HCC) care. The intervention combines: (1) patient education to improve HCC-related disease and treatment knowledge, (2) social needs and substance use screening with referral to social work and community resources, and (3) facilitated access to subspecialty cancer care through a multidisciplinary HCC tumor board. A total of 40 Black patients with Barcelona Clinic Liver Cancer (BCLC) stage 0, A, or downstaged B disease will be randomized to receive either the HCC Liver-Link intervention or usual care and followed for 6 months or until liver transplant waitlisting. Primary outcomes are time to receipt of curative therapies (liver transplantation or resection) and change in HCC-related knowledge. Findings will inform development of larger interventions to eliminate racial disparities in HCC outcomes.
∙ • Within UCSF criteria:
∙ Candidates are eligible or a standardized MELD or PELD exception if, before completing locoregional therapy, they have lesions that meet one of the following criteria:
• One Class 5 lesion greater than 5 cm and less than or equal to 8 cm
• two or three Class 5 lesions that meeting all of the following
‣ At least one lesion greater than 3cm
⁃ Each lesion less than or equal to 5 cm, and
⁃ A total diameter of all lesions less than or equal to 8cm
• Four or five Class 5 lesions each less than 3 cm, and a total diameter of all lesions less than or equal to 8 cm.
• Between 18-75 years old
• Have no more than two visits with an HCC-related provider
• Able to read, write, and speak English
• Any 1 of the following:
‣ Self-report as Black race (can be multiple races as long as 1 is Black)
⁃ Self-report as insured by Medicaid (+/- Medicare)
⁃ SVI (Social vulnerability index) \>= .75
⁃ Unmarried