Patterns of Comorbidity in Hepatocellular Carcinoma: A Network Perspective

Abstract

Hepatocellular carcinoma (HCC) is a common and fatal cancer. People with HCC report higher odds of comorbidity compared with people without HCC. To explore the association between HCC and medical comorbidity, we used routinely collected clinical data and applied a network perspective. In the network perspective, we used correlation analysis and community detection tests that described direct relationships among comorbidities. We collected 14,891 patients with HCC living in Jilin Province, China, between 2016 and 2018. Cirrhosis was the most common comorbidity of HCC. Hypertension and renal cysts were more common in male patients, while chronic viral hepatitis C, hypersplenism, hypoproteinemia, anemia and coronary heart disease were more common in female patients. The proportion of chronic diseases in comorbidities increased with age. The main comorbidity patterns of HCC were: HCC, cirrhosis, chronic viral hepatitis B, portal hypertension, ascites and other common complications of cirrhosis; HCC, hypertension, diabetes mellitus, coronary heart disease and cerebral infarction; and HCC, hypoproteinemia, electrolyte disorders, gastrointestinal hemorrhage and hemorrhagic anemia. Our findings provide comprehensive information on comorbidity patterns of HCC, which may be used for the prevention and management of liver cancer.

Comorbidity in Older Patients Hospitalized with Cancer in Northeast China based on Hospital Discharge Data

“…The results showed a strong association between liver cancer, cirrhosis and chronic viral hepatitis. The most common causes for liver cancer are chronic viral hepatitis B and C infection [39], and cirrhosis is a strong risk factor for liver cancer [40]. Liver cancer is frequently accompanied by one or more components of metabolic diseases, because metabolism is the most important function of the liver.…”

Systemic treatment of HCC in special populations

“…Due to partly overlapping risk factors, the prevalence of cardiovascular disease (CVD) in the general population, and the incidence in similar age groups, arterial hypertension, coronary heart disease, cerebrovascular disease, and thromboembolic events are frequent comorbidities in patients with HCC. 58 Patients with uncontrolled CVD or recent acute events, such as myocardial infarction, pulmonary embolism or stroke, are excluded from clinical trials assessing systemic treatments for HCC (Table 1). A large cross-sectional Chinese study (n = 22,500) showed that of 2,574 patients with advanced HCC, 25.1% had concomitant hypertension, 4.7% had coronary heart disease, 3% atrial fibrillation, and 2% heart failure.…”

Consensus on the secondary prevention of primary liver cancer

“…According to the global HCC BRIDGE (“Bridge to Better Outcomes in HCC”) study [ 4 ], among the 18,031 HCC patients in 14 countries, the mean age of onset in Japan, Europe, and North America was 69, 65, and 62 years, respectively, and in China and South Korea, 52 and 59 years, respectively. In a Chinese study [ 5 ] that included 14,891 cases of HCC from 2016 to 2018, the proportion of patients ≤ 39, 40–49, 50–59, 60–69, and ≥ 70 years old was 2.89, 14.59, 29.47, 35.26, and 17.79%, respectively; the proportion of male and female patients was 76.01% and 23.99%, respectively.…”