Chemotherapy combined with radiotherapy can benefit more unresectable HCC patients with portal and/or hepatic vein invasion: a retrospective analysis of the SEER database

Abstract

BackgroundThe purpose of this study is to evaluate the effects of chemotherapy and radiotherapy on the prognosis of unresectable HCC patients with portal and/or hepatic vein invasion.MethodsA retrospective analysis of unresectable HCC patients with portal and/or hepatic vein invasion registered in the Surveillance, Epidemiology, End Results (SEER) database was performed. The propensity score-matching (PSM) method was used to balance differences between groups. Overall survival (OS) and cancer-specific survival (CSS) were the interesting endpoints. OS was calculated from the date of diagnosis to the date of death caused by any cause or the last follow-up. CSS was defined as the interval between the date of diagnosis and date of death due only to HCC or last follow-up. OS and CSS were analyzed by using Kaplan-Meier analysis, Cox proportional hazards model, and Fine-Gray competing-risk model.ResultsA total of 2,614 patients were included. 50.2% patients received chemotherapy or radiotherapy and 7.5% patients received both chemotherapy and radiotherapy. Compared to the untreated group, chemotherapy or radiotherapy (COR) (HR = 0.538, 95% CI 0.495-0.585, p < 0.001) and chemotherapy and radiotherapy (CAR) (HR = 0.371, 95% CI 0.316-0.436, p < 0.001) showed better OS. In the COR group, Cox analysis results showed AFP, tumor size, N stage and M stage were independent risk factor of OS. Competing-risk analysis results showed AFP, tumor size and M stage were independent risk factor of CSS. In the CAR group, AFP and M stage were independent risk factors of OS. Competing-risk analysis results showed M stage were independent risk factor of CSS. Kaplan Meier analysis showed chemotherapy combined with radiotherapy significantly improves OS (10.0 vs. 5.0 months, p < 0.001) and CSS (10.0 vs. 6.0 months, p = 0.006) than monotherapy.ConclusionAFP positive and distant metastasis are the main risk factors affecting OS and CSS of unresectable HCC patients with portal and/or hepatic vein invasion. Chemotherapy combined with radiotherapy significantly improves OS and CSS of unresectable HCC patients with portal and/or hepatic vein invasion.

Risk factors for secondary thyroid cancer in patients with breast cancer: a propensity‑matched SEER analysis

“…Because the diagnostic criteria, examination instruments, and staging criteria may differ between years, we performed 1:4 propensity score matching according to the year of diagnosis to minimize confounding bias and to include as many control cases as possible to ensure representativeness 12 . The matched 4595 patients were randomly divided into training set and validation set in the ratio of 7:3, and the obtained training set was used to train the cox regression model, and the validation set was used to verify the stability of the model 15 , 16 . The results of univariate cox regression showed that the 11 factors included except ER were independent factors for secondary thyroid cancer in breast cancer patients, and the results of multivariate cox regression showed that age, ethnicity, location of primary tumor, whether or not to have radiotherapy, N-stage, and M-stage were independent factors for secondary thyroid cancer in breast cancer patients.…”

Construction of a Nomogram to Predict Overall Survival in Patients with Early-Onset Hepatocellular Carcinoma: A Retrospective Cohort Study

“…Tumor size is a significant factor that influences the prognosis of hepatocellular carcinoma (HCC), and it is commonly used as a crucial criterion for HCC staging and treatment guidelines [24]. Several multicenter studies focusing on surgically-resected HCC have consistently demonstrated that tumors measuring >5 cm are associated with a poorer prognosis than those measuring ≤5 cm [25][26][27]. The nomogram clearly illustrates the rela-tionship between the tumor size and prognosis, indicating that as the tumor size increases, the corresponding score also increases, indicating a worse prognosis.…”