Xuqi Sun1,2,3, Lingling Li3, Li Xu1,2, Zhongguo Zhou1,2, Jinbin Chen1,2, Juncheng Wang1,2, Yaojun Zhang4,5,6, Dandan Hu7,8,9, Minshan Chen1,2. 1. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China. 2. Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China. 3. Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510060, China. 4. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China. zhangyj@sysucc.org.cn. 5. Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China. zhangyj@sysucc.org.cn. 6. Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Dongfeng East Road 651, Guangzhou, Guangdong, 510000, People's Republic of China. zhangyj@sysucc.org.cn. 7. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China. hudd@sysucc.org.cn. 8. Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China. hudd@sysucc.org.cn. 9. Department of Liver Surgery, Sun Yat-Sen University Cancer Center, Dongfeng East Road 651, Guangzhou, Guangdong, 510000, People's Republic of China. hudd@sysucc.org.cn.
Abstract
BACKGROUND: Patients with cancer history are usually excluded from hepatocellular carcinoma (HCC) clinical trials. However, whether previous malignancy affects the oncological outcomes of HCC patients has not been fully assessed. This study aimed to evaluate whether prior cancer compromised the survival of HCC patients. METHODS: Patients with HCC were extracted from the Surveillance, Epidemiology, and End Results database between 2004 and 2015, and then they were classified into groups with and without prior cancer. The Kaplan-Meier and multivariate Cox regression analysis were adopted to evaluate whether prior cancer impacted clinical outcomes after propensity score matching (PSM) adjusting baseline differences. Validation was performed in the cohort from our institution. RESULTS: We identified 2642 HCC patients with prior cancer. After PSM, the median overall survival (OS) time were 14.5 and 12.0 months respectively for groups with and without prior cancer. Prior cancer did not compromise prognosis in patients with HCC (p = 0.49). The same tendency was found in subgroups stratified by tumor stages and cancer interval period: OS was similar between groups with and without prior cancer (both p values> 0.1). In the multivariate Cox regression model, prior cancer did not adversely impact patients' survival (HR: 1.024; 95% CI: 0.961-1.092). In the validation cohort from our institution, prior cancer had no significant association with worse outcomes (p = 0.48). CONCLUSION: For HCC patients, prior cancer did not compromise their survival, regardless of tumor stage and cancer interval period. Exclusion criteria for HCC clinical trials could be reconsidered.
BACKGROUND:Patients with cancer history are usually excluded from hepatocellular carcinoma (HCC) clinical trials. However, whether previous malignancy affects the oncological outcomes of HCCpatients has not been fully assessed. This study aimed to evaluate whether prior cancer compromised the survival of HCCpatients. METHODS:Patients with HCC were extracted from the Surveillance, Epidemiology, and End Results database between 2004 and 2015, and then they were classified into groups with and without prior cancer. The Kaplan-Meier and multivariate Cox regression analysis were adopted to evaluate whether prior cancer impacted clinical outcomes after propensity score matching (PSM) adjusting baseline differences. Validation was performed in the cohort from our institution. RESULTS: We identified 2642 HCCpatients with prior cancer. After PSM, the median overall survival (OS) time were 14.5 and 12.0 months respectively for groups with and without prior cancer. Prior cancer did not compromise prognosis in patients with HCC (p = 0.49). The same tendency was found in subgroups stratified by tumor stages and cancer interval period: OS was similar between groups with and without prior cancer (both p values> 0.1). In the multivariate Cox regression model, prior cancer did not adversely impact patients' survival (HR: 1.024; 95% CI: 0.961-1.092). In the validation cohort from our institution, prior cancer had no significant association with worse outcomes (p = 0.48). CONCLUSION: For HCCpatients, prior cancer did not compromise their survival, regardless of tumor stage and cancer interval period. Exclusion criteria for HCC clinical trials could be reconsidered.
Authors: Mollie W Howerton; M Chris Gibbons; Charles R Baffi; Tiffany L Gary; Gabriel Y Lai; Shari Bolen; Jon Tilburt; Teerath Peter Tanpitukpongse; Renee F Wilson; Neil R Powe; Eric B Bass; Jean G Ford Journal: Cancer Date: 2007-02-01 Impact factor: 6.860
Authors: P N Lara; R Higdon; N Lim; K Kwan; M Tanaka; D H Lau; T Wun; J Welborn; F J Meyers; S Christensen; R O'Donnell; C Richman; S A Scudder; J Tuscano; D R Gandara; K S Lam Journal: J Clin Oncol Date: 2001-03-15 Impact factor: 44.544
Authors: Michael S Simon; Wei Du; Lawrence Flaherty; Philip A Philip; Patricia Lorusso; Cheryl Miree; Daryn Smith; Diane R Brown Journal: J Clin Oncol Date: 2004-04-13 Impact factor: 44.544
Authors: Janet S de Moor; Angela B Mariotto; Carla Parry; Catherine M Alfano; Lynne Padgett; Erin E Kent; Laura Forsythe; Steve Scoppa; Mark Hachey; Julia H Rowland Journal: Cancer Epidemiol Biomarkers Prev Date: 2013-03-27 Impact factor: 4.254