Hepatocellular carcinoma in a rapidly growing community: Epidemiology, clinico-pathology and predictors of extrahepatic metastasis

Elmoghazy, Walid; Ahmed, Khalid; Vijay, Adarsh; Kamel, Yasser; Elaffandi, Ahmed; El-Ansari, Walid; Rasul, Kakil Ibrahim; Khalaf, Hatem

doi:10.1016/j.ajg.2019.01.006

Cited by 12 publications

(11 citation statements)

References 22 publications

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“…Chen et al (2019) pointed out that bone metastasis was significantly associated with brain metastasis from HCC. Besides, positive AFP, bilobar HCC lesions, multiplicity of HCC lesions, and primary tumor size ≥5 cm at initial diagnosis were also the independent predictors for distant metastases of HCC (Lee et al, 2019; Elmoghazy et al, 2019; Carr & Guerra, 2016; Can et al, 2014). These indicators reflected the invasiveness of primary tumor and this was an explanation that these indicators were risk factors for extrahepatic metastases from HCC.…”

Section: Discussionmentioning

confidence: 97%

Risk and prognostic nomograms for hepatocellular carcinoma with newly-diagnosed pulmonary metastasis using SEER data

Ye¹,

Wang²,

Hu³

et al. 2019

PeerJ

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Purpose This research aimed to identify risk factors of pulmonary metastasis (PM) from hepatocellular carcinoma (HCC) and prognostic factors of patients with PM from HCC at initial diagnosis. Methods Patients diagnosed with HCC between 2010 and 2015 were reviewed retrospectively in the Surveillance, Epidemiology, and End Results (SEER) database. Patients with PM from HCC at initial diagnosis were identified from the entire cohort. Predictors for PM from HCC were identified by multivariate logistic regression analysis. Independent prognostic factors for patients with PM were determined by univariate and multivariate Cox regression analysis. Nomograms were also constructed for quantifying risk of metastasis and overall survival estimation visually. Results Our research included 30,641 patients diagnosed with HCC, of whom 1,732 cases were with PM from HCC at initial diagnosis. The risk factors causing PM from HCC were age (P = 0.001), race (P < 0.001), primary tumor size (P < 0.001), T stage (P < 0.001), N stage (P < 0.001), alpha-fetoprotein (P < 0.001), bone metastasis (P < 0.001), brain metastasis (P < 0.001), and intrahepatic metastasis (P < 0.001). The significantly prognostic factors for overall survival were age (P = 0.014), T stage (P = 0.009), surgical approach (P < 0.001), and chemotherapy (P < 0.001). Harrell’s C-index statistics of two nomograms were 0.768 and 0.687 respectively, indicating satisfactory predictive power. Conclusions This research provided evaluation of risk factors and prognosis for patients with PM from HCC. Two nomograms we developed can be convenient individualized tools to facilitate clinical decision-making.

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Section: Discussionmentioning

confidence: 97%

Risk and prognostic nomograms for hepatocellular carcinoma with newly-diagnosed pulmonary metastasis using SEER data

Ye¹,

Wang²,

Hu³

et al. 2019

PeerJ

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“…Therefore, the prognosis remains poor, and the 5-year survival rate was less than 20% [3]. Moreover, 14.0-36.7% of patients have distant metastasis at initial diagnosis [4,5], and the prognosis was poorer in HCC patients with extrahepatic metastasis than patients without it [6].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and prognostic nomograms for bone metastasis in hepatocellular carcinoma

Yang

Huang

et al. 2020

BMC Cancer

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Background: Bone metastasis (BM) is one of the common sites of hepatocellular carcinoma (HCC), and the prognosis of BM patients is worse than patients without it. Our study aimed to identify predictors and prognostic factors of BM in HCC patients and develop two nomograms to quantify the risk of BM and the prognosis of HCC patients with BM. Methods: We retrospectively reviewed the data of patients who were diagnosed as HCC between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database. Independent predictors for BM from HCC patients were determined by the univariate and multivariate logistic regression analysis. Independent prognostic factors for HCC patients with BM were identified by univariate and multivariate Cox regression analysis. Two nomograms were established and evaluated by calibration curves, receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). Results: Nine thousand and forty-seven patients were included. The independent risk factors of BM in newly diagnosed HCC patients are sex, grade, T stage, and N stage. The independent prognostic factors for HCC patients with BM are radiotherapy, chemotherapy, and lung metastasis. The AUC of diagnostic nomogram were 0.726 in the training set and 0.629 in the testing set. For the prognostic nomogram, the AUCs of 6-, 9-, and 12-months were 0.753, 0.799, and 0.732 in the training set and 0.698, 0.770, and 0.823 in the validation set. The calibration curve and DCA indicated the good performance of the nomogram. Conclusions: Two nomograms were established to predict the incidence of BM in HCC patients and the prognosis of HCC patients with BM, respectively. Both nomograms have satisfactory accuracy, and clinical utility may benefit for clinical decision-making.

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“…Manuscript to be reviewed tumor size ≥ cm at initial diagnosis were also the independent predictors for distant metastases of HCC (Lee et al, 2019;Elmoghazy et al, 2019;Carr & Guerra, 2016;Can et al, 2014). These indicators reflected the invasiveness of primary tumor and this was an explanation that these indicators were risk factors for extrahepatic metastases from HCC.…”

Section: Discussionmentioning

confidence: 97%

Peer Review #1 of "Risk and prognostic nomograms for hepatocellular carcinoma with newly-diagnosed pulmonary metastasis using SEER data (v0.1)"

2019

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This research aimed to identify risk factors of pulmonary metastasis (PM) from hepatocellular carcinoma (HCC) and prognostic factors of patients with PM from HCC at initial diagnosis. Methods. Patients diagnosed with HCC between 2010 and 2015 were reviewed retrospectively in the Surveillance, Epidemiology, and End Results (SEER) database. Patients with PM from HCC at initial diagnosis were identified from the entire cohort. Predictors for PM from HCC were identified by multivariate logistic regression analysis. Independent prognostic factors for patients with PM were determined by univariate and multivariate Cox regression analysis. Nomograms were also constructed for quantifying risk of metastasis and overall survival estimation visually. Results. Our research included 30641 patients diagnosed with HCC, of whom 1732 cases were with PM from HCC at initial diagnosis. The risk factors causing PM from HCC were age (P = 0.001), race (P < 0.001), primary tumor size (P < 0.001), T stage (P < 0.001), N stage (P < 0.001), AFP (P < 0.001), bone metastasis (P < 0.001), brain metastasis (P < 0.001), and intrahepatic metastasis (P < 0.001). The significantly prognostic factors for overall survival (OS) were age (P = 0.014), T stage (P = 0.009), surgical approach (P < 0.001), and chemotherapy (P < 0.001). Harrell's C-index statistics of two nomograms were 0.768 and 0.687 respectively, indicating satisfactory predictive power. Conclusions. This research provided evaluation of risk factors and prognosis for patients with PM from HCC. Two nomograms we developed can be convenient individualized tools to facilitate clinical decisionmaking.

show abstract

Hepatocellular carcinoma in a rapidly growing community: Epidemiology, clinico-pathology and predictors of extrahepatic metastasis

Cited by 12 publications

References 22 publications

Risk and prognostic nomograms for hepatocellular carcinoma with newly-diagnosed pulmonary metastasis using SEER data

Risk and prognostic nomograms for hepatocellular carcinoma with newly-diagnosed pulmonary metastasis using SEER data

Diagnostic and prognostic nomograms for bone metastasis in hepatocellular carcinoma

Peer Review #1 of "Risk and prognostic nomograms for hepatocellular carcinoma with newly-diagnosed pulmonary metastasis using SEER data (v0.1)"

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