Hani Oweira1,2, Jan Schmidt3, Daniel Helbling4, Ulf Petrausch5, Othmar Schöb3, Arianeb Mehrabi2, Anwar Giryes1, Hazem Elhadedy2, Omar Abdel-Rahman6. 1. a Surgery , Swiss Cancer Institute , Cham , Switzerland. 2. b Department of General, Visceral and Transplant Surgery , University of Heidelberg , Heidelberg , Germany. 3. c Surgery , Surgical Center Zurich - Hirslanden Hospital Zurich , Zurich , Switzerland. 4. d Medical Oncology , Gastrointestinal Tumor Center Zurich (GITZ) , Zurich , Switzerland. 5. e Medical Oncology , Swiss Tumor Immunology Institute (SwissTII) , Zurich , Switzerland. 6. f Clinical Oncology Department, Faculty of Medicine , Ain Shams University , Cairo , Egypt.
Abstract
BACKGROUND: Population-based data on the development of second malignant neoplasms (SMNs) following the diagnosis of hepatocellular carcinoma (HCC) are uncommon. We evaluated this clinical vignette in HCC patients within the Surveillance, Epidemiology and End Results (SEER) database. METHODS: The SEER database (1973-2012) was queried using the SEER*Stat program to determine the clinico-pathological features of HCC patients with more than one year survival who developed SMNs. Standardized incidence ratios (SIRs) were calculated to determine the risk of each type of subsequent cancers. Relative risk was assessed to determine the impact of liver transplantation on the development of second malignant neoplasms. RESULTS: On SIR analysis, the following sites have an enhanced risk of developing an SMN following the diagnosis of HCC: tongue, anal canal, liver, lung, kidney, thyroid, non-Hodgkin lymphoma (both nodal and extra-nodal disease) and acute monocytic leukemia (P < 0.05 for all sites). A significantly higher RR was found for the development of lung cancer (RR = 2.096), thyroid cancer (RR = 3.045) and non-Hodgkin lymphoma (RR = 3.822) among patients who underwent liver transplantation compared to those who did not (P < 0.05). CONCLUSION: There is an excess risk for developing a number of SMNs among patients diagnosed with HCC.
BACKGROUND: Population-based data on the development of second malignant neoplasms (SMNs) following the diagnosis of hepatocellular carcinoma (HCC) are uncommon. We evaluated this clinical vignette in HCC patients within the Surveillance, Epidemiology and End Results (SEER) database. METHODS: The SEER database (1973-2012) was queried using the SEER*Stat program to determine the clinico-pathological features of HCC patients with more than one year survival who developed SMNs. Standardized incidence ratios (SIRs) were calculated to determine the risk of each type of subsequent cancers. Relative risk was assessed to determine the impact of liver transplantation on the development of second malignant neoplasms. RESULTS: On SIR analysis, the following sites have an enhanced risk of developing an SMN following the diagnosis of HCC: tongue, anal canal, liver, lung, kidney, thyroid, non-Hodgkin lymphoma (both nodal and extra-nodal disease) and acute monocytic leukemia (P < 0.05 for all sites). A significantly higher RR was found for the development of lung cancer (RR = 2.096), thyroid cancer (RR = 3.045) and non-Hodgkin lymphoma (RR = 3.822) among patients who underwent liver transplantation compared to those who did not (P < 0.05). CONCLUSION: There is an excess risk for developing a number of SMNs among patients diagnosed with HCC.
Entities:
Keywords:
Liver cancer; non-Hodgkin lymphoma; second malignant neoplasm