Ming-Lun Yeh, Ching-I Huang, Chung-Feng Huang, Ming-Yen Hsieh, Zu-Yau Lin, Jee-Fu Huang, Chia-Yen Dai, Ming-Lung Yu, Shinn-Cherng Chen , Wan-Long Chuang Published: September 28,
2017 https://doi.org/10.1371/journal.pone.0184878
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Abstract
Background
The impact of additional extra-hepatic primary cancer (EHPC) on the outcomes of patients with hepatocellular carcinoma (HCC) remains uncertain.
Methods
We retrospectively analyzed the cancer registration database from a tertiary hospital in Southern Taiwan. Patients who were diagnosed with HCC from 2008 to 2012 were enrolled. Overall survival (OS), HCC-specific survival and recurrence after curative therapy were analyzed and compared between the patients with and the patients without EHPC.
Results
EHPC was found in 121/1506 (8.0%) patients. HCC patients with EHPC were older, more likely to be classified as Child-Pugh A, less likely to have viral hepatitis B or C, more likely to be single, had early stage HCC and received curative therapy for HCC. The OS did not significantly differ between the patients with and without EHPC(p = 0.061). However, significantly higher HCC-specific survival was observed in patients with EHPC (p<0.001), and a higher rate of non-HCC mortality was demonstrated in patients with EHPC (54.4% vs 9.3%). The subgroup analysis revealed better OS in patients with EHPC who were older than 65, had viral hepatitis B or C, had non-stage 1 HCC, had non-early stage BCLC and received non-curative therapy. Conversely, patients with HCC stage 1 who received curative therapy exhibited worse OS if they also had EHPC. The analysis of recurrence after curative therapy showed no difference between the two groups.
Conclusions
Our results implied that extra-hepatic primary cancer (EHPC) did not affect overall survival (OS), but HCC-related survival was better in patients with EHPC. Based on these findings, the management of additional primary cancer is warranted.
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