Impact of homogeneous and heterogeneous risk factors on the incidence and prognosis of brain metastases in patients with hepatocellular carcinoma

Lin, Xiaoning; Zhang, Pengfei; Huang, Rong; Huang, Yanlin; Sun, Jin; Zheng, Huili; Tian, Xin; Wang, Xiaomin

doi:10.21037/apm-20-1012

Cited by 5 publications

(5 citation statements)

References 27 publications

(43 reference statements)

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“…HCC has a poor prognosis, with a 5-year overall survival of 18%, especially for patients with brain metastases, with a median OS of 1.2–2.4 months [ 3 , 4 ] and a very high mortality rate. However, due to the low incidence of HCC with BMS, overall accounting for 0.2%–2.2% [ 5 ], poor prognosis, and lack of specific symptoms of early BMS, clinicians rarely pay attention to HCC.…”

Section: Introductionmentioning

confidence: 99%

“…Due to the difficulty of early diagnosis of BMS, and HCC patients often spread to other extrahepatic sites before BMS, the indications for the treatment of HCC patients with BMS are a major challenge for surgeons. Early diagnosis of BMS, radiotherapy combined with molecular targeted therapy and immunotherapy, can bring certain treatment opportunities for advanced HCC patients with BMS [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Risk Factors for Brain Metastasis of Hepatocellular Carcinoma

Wang

Guo

Zhang

et al. 2022

Journal of Healthcare Engineering

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Hepatocellular carcinoma (HCC) is a common malignancy with high mortality, especially in HCC patients with brain metastases (BMS). However, few studies have investigated the risk factors for BMS among HCC patients based on large-scale population. The study involved clinical data of 36,091 patients who met the inclusion criteria from the SEER database, from 2004 to 2016. Univariate analysis and multifactor logistics regression analysis was used to analyze risk factors affecting BMS among HCC patients. This study revealed that BMS occurred in 108 of 36,091 patients, with an incidence of 0.33%. Median survival was 7 months for patients with BMS, but 12 months for patients without BMS. Univariate analysis showed that pathological low differentiation and undifferentiation, lymph node metastasis, no surgical treatment, and no chemotherapy and radiotherapy increased risk of BMS (P < 0.05). Multivariate analysis suggested that no surgical treatment and no chemotherapy or radiotherapy were independent risk factors for BMS (P < 0.001). Our findings highlighted that the independent risk factors for BMS were no surgical treatment, no chemotherapy, and no radiotherapy.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk Factors for Brain Metastasis of Hepatocellular Carcinoma

Wang

Guo

Zhang

et al. 2022

Journal of Healthcare Engineering

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“…Shi et al 16 noted that gender, grade, N stage, tumor size, and intrahepatic metastasis were significantly associated with lung metastasis in ICC. Lin et al 17 found that age, grade, surgery, radiotherapy, chemotherapy, bone metastasis, and lung metastasis were independently positively associated with BM in the HCC cohort. These factors also reflect the invasion ability of the primary tumor to varying degrees, thus suggesting that these indicators can be used as risk factors for extrahepatic metastasis.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic and prognostic nomograms for newly diagnosed intrahepatic cholangiocarcinoma with brain metastasis: A population-based analysis

Liu

Yang

et al. 2022

Exp Biol Med (Maywood)

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Brain metastasis (BM) is one of the rare metastatic sites of intrahepatic cholangiocarcinoma (ICC). ICC with BM can seriously affect the quality of life of patients and lead to a poor prognosis. The aim of this study was to establish two nomograms to estimate the risk of BM in ICC patients and the prognosis of ICC patients with BM. Data on 19,166 individuals diagnosed with ICC were retrospectively collected from the Surveillance, Epidemiology, and End Results (SEER) database. Independent risk factors and prognostic factors were identified by the logistic and the Cox regression, respectively. Next, two nomograms were developed, and their discrimination was estimated by concordance index ( C-index) and calibration plots, while the clinical benefits of the prognostic nomogram were evaluated using the receiver operating characteristic (ROC) curves, the decision curve analysis (DCA), and the Kaplan–Meier analyses. The independent risk factors for BM were T stage, N stage, surgery, alpha-fetoprotein (AFP) level, and tumor size. T stage, surgery, radiotherapy, and bone metastasis were prognostic factors for overall survival (OS). For the prognostic nomogram, the C-index was 0.759 (95% confidence interval (CI) = 0.745–0.773) and 0.764 (95% CI = 0.747–0.781) in the training and the validation cohort, respectively. The calibration curves revealed a robust agreement between predictions and actual observations probability. The area under curves (AUCs) for the 3-, 6-, and 9-month OS were 0.721, 0.727, and 0.790 in the training cohort and 0.702, 0.777, and 0.853 in the validation cohort, respectively. The DCA curves yielded remarkable positive net benefits over a wide range of threshold probabilities. The Kaplan–Meier analysis illustrated that the nomogram could significantly distinguish the population with different survival risks. We successfully established the two nomograms for predicting the incidence of BM and the prognosis of ICC patients with BM, which may assist clinicians in choosing more effective treatment strategies.

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“…Non-White race and advanced stage were associated with poor prognosis. Many studies have found that race could serve as a prognostic factor for various cancers such as hepatocellular carcinoma, [16] lymphoma, [17][18][19] and breast cancer. [20] Lower treatment rates and delayed onset of treatment may account for this phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and survival outcomes of primary splenic cancers

Lei

Huang²,

Li³

et al. 2022

Medicine

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Primary splenic cancers represent a small number of cancer cases and studies on its clinicopathological features and outcomes are limited. Splenic lymphomas and primary splenic angiosarcoma (PSA) are the 2 most common histological types of splenic cancers. This population-based study aimed to investigate the clinical characteristics and survival outcomes of patients with splenic lymphomas or PSA. Patients diagnosed with splenic lymphomas or PSA between 2000 and 2015 were identified from the Surveillance Epidemiology and End Results database of the National Cancer Institutes. Overall survival (OS) and cancer-specific survival (CSS) rates were calculated using the Kaplan–Meier method. A Cox proportional hazard models were used to identify independent predictors of cancer-specific mortality. A total of 700 patients with splenic lymphoma and 48 patients with PSA were included in this study. The median age of patients with splenic lymphoma was 65 years and 57 years for patients with PSA. For patients with splenic lymphoma, the most prevalent histological subtypes were splenic marginal zone lymphoma and diffuse large B-cell lymphoma. A total of 52.6% of the cases had stage IV disease based on the Ann Arbor staging system. Five-year OS and CSS were 76.9% and 83.4%, respectively. Multivariate analysis revealed that independent predictors of splenic lymphoma CSS included race, stage, chemotherapy, and histological subtype. However, a much shorter OS time was seen in the PSA cohort which had a 5-year OS of 11.8%, a median OS of 10.0 months and the 5-year CSS of 12.4%. Chemotherapy was correlated with better outcomes in patients with PSA. However, the survival benefits of surgery for splenic cancer were not statistically significant in our study. The current study is the largest cohort of primary splenic cancer presented in literature based on the Surveillance Epidemiology and End Results database and our large series describe the characteristics and survival outcomes of such rare diseases which may provide reliable information for further studies and clinicians.

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Impact of homogeneous and heterogeneous risk factors on the incidence and prognosis of brain metastases in patients with hepatocellular carcinoma

Cited by 5 publications

References 27 publications

Risk Factors for Brain Metastasis of Hepatocellular Carcinoma

Risk Factors for Brain Metastasis of Hepatocellular Carcinoma

Diagnostic and prognostic nomograms for newly diagnosed intrahepatic cholangiocarcinoma with brain metastasis: A population-based analysis

Characteristics and survival outcomes of primary splenic cancers

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