A clinical and radiologic study of primary liver cancer associated with extrahepatic primary cancer

Abstract

In a consecutive series of 393 patients with excised and pathologically proven primary liver cancer (PLC)—including 374 hepatocellular carcinomas (CCC), nine cholangiocellular carcinomas (CCC), and ten mixed type of HCC and CCC—33 patients (8.4%) had one or two other malignancies in the extrahepatic organ(s). Of these, 29 had double cancers and four, triple cancers. This was synchronous in 11 patients, metachronous in 20 (including 18 with double cancers and two with triple cancers) and synchronous and metachronous in two with triple cancers. Metachronous cancer was found in 21 patients 1 year before hepatectomy for PLC and in three patients, 1 year after hepatectomy. The median age of PLC patients with multiple primary cancer (MPC) was 63.6 ± 6.9 years; this was significantly greater than that of PLC patients without MPC (P < 0.01). The associated cancer was gastric cancer in 11 patients (29.7%), colorectal cancer in six, pharyngeal cancer in four, and other cancers in ten different organs in 16. Thirteen of 22 patients had a history of blood transfusion. The incidence of liver cirrhosis in PLC associated with MPC (57.6%) was significantly lower than that without MPC (82.8%, P < 0.01). The differential diagnosis of PLC from liver metastasis was possible retrospectively in 78.6% using sonograms, 79.3% using computed tomograms, and 91.3% using angiograms. The survival rates of patients with PLC with (n = 33) and without (n = 299) MPC who had undergone hepatectomy were 97.0% and 85.4% at 1 year, 55.5% and 59.5% at 3 years, and 40.5% and 40.1% at 5 years, respectively. There was no significant difference between the survival rates of those who underwent operations for PLC and extrahepatic primary cancer(s) synchronously and metachronously.

Clinical features and outcome of multiple primary malignancies involving hepatocellular carcinoma: A long-term follow-up study

“…Therefore, we analyzed the frequency of EHPM according to tumor types. Contrary to our expectations drawn from the results of previous studies conducted in Japan [4] and Western countries [23], nasopharynx cancer ranked first in extrahepatic tumors, not gastric nor colorectal cancer. Nasopharyngeal carcinoma (NPC) is a disease with remarkable geographic distribution and a high incidence rate in South China.…”

“…Although small sample-sized studies were performed in Japan [4,5], Taiwan [6], and Western countries [7], none of them were from Mainland China, an area with a high incidence of HCC (> 20 annual cases per 10 5 people) [8]. This retrospective study was designed to characterize MPM patients, to explore long-term prognosis, and to investigate the impact of extrahepatic primary malignancy (EHPM) on survival of HCC in China.…”

Intracranial Metastasis in a Patient with Hepatocellular Carcinoma and Gastric Cancer

“…In Western countries, prostate, colon, and lung cancers are the most commonly observed in multiple primary malignancies involving HCC [7]. In contrast, gastric cancer predominates in Asian countries [8, 9]. …”

Allelic loss of 14q32 in the pathogenesis of gastrointestinal and ampullary malignancies: mapping of the target region to a 17�cM interval

“…The carcinogenic mechanisms underlying their induction are poorly understood, except for a close relationship with gallstones. Despite that, biliary tract cancers have been reported to co-occur with cancers of the prostate, ovary, breast, esophagus, rectum, pancreas, liver, colorectum, and stomach (Renault et al 1978;Kitano et al 1984;Schlossberg et al 1988;Takayasu et al 1992).…”