Pattern of distant extrahepatic metastases in primary liver cancer: a SEER based study

Abstract

Background and Aims: Primary liver cancer remains still the common cause of cancer-related deaths globally and the prognosis for patients with extrahepatic metastasis is poor. The aim of our study was to assess extrahepatic metastatic pattern of different histological subtypes and evaluate prognostic effects of extrahepatic metastasis in patients with advanced disease. Methods: Based on the Surveillance, Epidemiology and End Results (SEER) database, eligible patients diagnosed with primary liver cancer was identified between 2010 to 2012. We adopted Chi-square test to compared metastasis distribution among different histological types. We compared survival difference of patients with different extrahepatic metastasises by Kaplan-Meier analysis. Cox proportional hazard models were performed to identify other prognostic factors of overall survival. Results: We finally identified 8677 patients who were diagnosed with primary liver cancer from 2010 to 2012 and 1775 patients were in distant metastasis stages. Intrahepatic cholangiocarcinoma was more invasive and had a higher percentage of metastasis compared with hepatocellular carcinoma. Lung was the most common metastasis and brain was the least common site for both hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Extrahepatic metastasis could consider as an independent prognostic factor for patients with liver cancer. Patients with brain metastasis had the worst prognosis, compared with other metastasis in overall survival (OS) and cancer-specific survival (CSS) analysis. Conclusions: Different histological subtypes of liver cancer had different metastasis patterns. There were profound differences in risk of mortality among distant extrahepatic metastatic sites. Results from our studies would provide some information for follow-up strategies and future studies.

The prognostic analysis of different metastatic patterns in advanced liver cancer patients: A population based analysis

“…Metastatic LCa represents a heterogeneous disease; clinical outcomes are highly variable and depend on the underlying tumor biology and patient characteristics[ 20 , 21 ]. The prognostic influence of metastasis at initial diagnosis and factors associated with specific organ involvement have been understudied[ 22 , 23 ]. Nevertheless, there was still no study that focused on the prognosis of different distant metastases pattern in LCa.…”

Peer Review #2 of "Effect of adjuvant radioactive iodine therapy on survival in rare oxyphilic subtype of thyroid cancer (Hürthle cell carcinoma) (v0.1)"

“…The SEER program is the largest publicly available cancer dataset containing information on cancer incidence, patient characteristics, and survival from various locations throughout the United States, which represents approximately 28% of the U.S. population (Wu et al 2017). In our study, we signed a SEER research data agreement form to access the SEER data.…”

Population-Based analysis for newly diagnosed hepatocellular carcinoma with brain metastases

“…1,2 Incidence rates continue to increase rapidly for hepatocellular carcinoma, by about 3% per year in women and 4% per year in men. 3 The most common hematogenic pathway of metastases for primary liver tumors is over the hepatic veins and thus to the lungs, bones and following that the brain 4,5 . Brain metastases from hepatocellular carcinoma (HCC) were thought to be very rare but data only based on estimates.…”