Meta-analysis of the impact of extrahepatic primary malignancy on survival of patients with multiple primary malignancies involving hepatocellular carcinoma

doi:10.3877/cma.j.issn.1674-0793.2014.05.017

Abstract

Abstract:

Objective

To assess the impact of extrahepatic primary malignancy (EHPM) on survival of patients with multiple primary malignancies (MPM) involving hepatocellular carcinoma (HCC).

Methods

All studies published including survival comparison between MPM involving HCC and HCC-alone were systematically reviewed. The studies were evaluated strictly and adopted in rash quality by means of Meta analysis. The odds ratio (OR) for death during the time to follow-up between the patients with MPM involving HCC and HCC-alone were calculated. And the effect of EHPM for survival in patients with MPM involving HCC was evaluated.

Results

Totally six studies including 2 431 cases were analyzed. The cumulative cases in MPM involving HCC group were 207, in which 136 were dead, while in HCC-alone group were 2 224 and 1 598 respectively. The pooled OR was 0.93, with a 95% confidence interval (0.67,1.28).

Conclusions

The overall OR for death is neither decreased nor increased in patients with EHPM. MPM involving HCC does not imply a worse prognosis and those patients should not be excluded from curative therapies. We need to prioritize curative treatment intention for HCC independently of the EHPM.

Key words: Hepatocellular carcinoma, Multiple primary malignancies, Survival, Meta analysis

Yijie Li, Chuangxin Huang, Mei Xiao, Qing'an Zeng. Meta-analysis of the impact of extrahepatic primary malignancy on survival of patients with multiple primary malignancies involving hepatocellular carcinoma[J]. Chinese Archives of General Surgery(Electronic Edition), 2014, 08(05): 408-411.

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URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2014.05.017

https://zhptwkxwx.cma-cmc.com.cn/EN/Y2014/V08/I05/408

Figures/Tables 4

References 15

[1]	Zeng QA,Qiu J,Zou R, et al. Clinical features and outcome of multiple primary malignancies involving hepatocellular carcinoma: a long-term follow-up study[J]. BMC Cancer, 2012, 12: 148.
[2]	Fernandez-Ruiz M,Guerra-Vales JM,Castelbon-Fernandez FJ, et al. Multiple primary malignancies in Spanish patients with hepatocellular carcinoma: analysis of a hospital-based tumor registry[J]. J Gastroenterol Hepatol, 2009, 24(8): 1424-1430.
[3]	Nzeako UC,Goodman ZD,Ishak KG. Association of hepatocellular carcinoma in North American patients with extrahepatic primary malignancies[J]. Cancer, 1994, 74(10): 2765-2771.
[4]	Wong LL,Lurie F,Takanishi DM Jr. Other primary neoplasms in patients with hepatocellular cancer: prognostic implications?[J]. Hawaii Med J, 2007, 66(8): 204, 206-208.
[5]	Takayasu K,Kasugai H,Ikeya S, et al. A clinical and radiologic study of primary liver cancer associated with extrahepatic primary cancer[J]. Cancer, 1992, 69(1): 45-51.
[6]	Shimada M,Takenaka K,Fujiwara Y, et al. Characteristics of hepatocellular carcinoma associated with extrahepatic primary malignancies in southern Japan[J]. Am J Gastroenterol,1996, 91(4): 754-758.
[7]	Jemal A,Bray F,Center MM, et al. Global cancer statistics[J]. CA Cancer J Clin, 2011, 61(2): 69-90.
[8]	张红卫,黄超有,林树文, 等. 索拉非尼对肝癌术后早期肝再生的影响[J/CD]. 中华普通外科学文献:电子版, 2013, 7(6): 472-476.
[9]	陈东,赵鹏,陈伟, 等. 索拉非尼治疗晚期原发性肝癌的单中心经验[J/CD]. 中华普通外科学文献:电子版, 2012, 6(6): 507-512.
[10]	Hiraoka A,Hirooka M,Ochi H, et al. Importance of screening for synchronous malignant neoplasms in patients with hepatocellular carcinoma: impact of FDG PET/CT[J]. Liver Int, 2013, 33(7): 1085-1091.
[11]	Wu WC,Chen YT,Hwang CY, et al. Second primary cancers in patients with hepatocellular carcinoma: a nationwide cohort study in Taiwan[J]. Liver Int, 2013, 33(4): 616-623.
[12]	Bruix J,Sherman M. Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma[J]. Hepatology, 2005, 42(5): 1208-1236.
[13]	谭国胜,向贤宏,张冰, 等. 经导管动脉化疗栓塞在肝细胞癌骨转移治疗中的应用初探[J/CD]. 中华普通外科学文献:电子版, 2013, 7(1): 21-25.
[14]	黄亮,刘继红,元云飞, 等. 上皮性卵巢癌肝转移的治疗及预后影响因素[J/CD]. 中华普通外科学文献:电子版, 2008, 2(6): 479-483.
[15]	邱春辉,赵辉,陈湖岸, 等. 肝癌肝移植术后肿瘤复发的治疗策略[J/CD]. 中华普通外科学文献:电子版, 2011, 5(4): 320-325.

第一作者，发表年	国家	性别	年龄（岁）	患者例数	肝外肿瘤好发部位	肝癌治疗
第一作者，发表年	国家	(男:女)	±s	多原发癌组/肝癌组	肝外肿瘤好发部位	肝癌治疗
Takayasu，1992^[5]	日本	29:4	63.6±6.9	33/299	胃、结直肠、咽喉	手术
Nzeako，1994^[3]	美国	11:1	69.2±2.1	57/1008	前列腺、结直肠、肺	综合
Shimada，1996^[6]	日本	33:8	61.2±8.7	41/249	胃、结直肠、泌尿生殖	手术
Wong，2007^[4]	美国	2.3:1	65.6±6.5	23/283	泌尿生殖、结直肠、乳腺	综合
Fernandez-Ruiz，2009^[2]	西班牙	5:1	67.7±9.7	18/245	结直肠、头颈部、泌尿生殖	综合
Zeng，2012^[1]	中国	30:5	56.3±12.6	35/140	鼻咽、结直肠、肺	手术

第一作者，发表年	国家	性别	年龄（岁）	患者例数	肝外肿瘤好发部位	肝癌治疗
第一作者，发表年	国家	(男:女)	±s	多原发癌组/肝癌组	肝外肿瘤好发部位	肝癌治疗
Takayasu，1992^[5]	日本	29:4	63.6±6.9	33/299	胃、结直肠、咽喉	手术
Nzeako，1994^[3]	美国	11:1	69.2±2.1	57/1008	前列腺、结直肠、肺	综合
Shimada，1996^[6]	日本	33:8	61.2±8.7	41/249	胃、结直肠、泌尿生殖	手术
Wong，2007^[4]	美国	2.3:1	65.6±6.5	23/283	泌尿生殖、结直肠、乳腺	综合
Fernandez-Ruiz，2009^[2]	西班牙	5:1	67.7±9.7	18/245	结直肠、头颈部、泌尿生殖	综合
Zeng，2012^[1]	中国	30:5	56.3±12.6	35/140	鼻咽、结直肠、肺	手术

治疗方法	总OR	95% CI	同质性检验			Meta分析统计量
治疗方法	总OR	95% CI	Q	P	I²	Z	P
手术治疗	0.74	0.48～1.12	1.50	0.47	0	1.44	0.15
综合治疗	1.31	0.77～2.24	1.10	0.58	0	1.01	0.31
手术+综合	0.93	0.67～1.28	5.21	0.39	4	0.45	0.65

治疗方法	总OR	95% CI	同质性检验			Meta分析统计量
治疗方法	总OR	95% CI	Q	P	I²	Z	P
手术治疗	0.74	0.48～1.12	1.50	0.47	0	1.44	0.15
综合治疗	1.31	0.77～2.24	1.10	0.58	0	1.01	0.31
手术+综合	0.93	0.67～1.28	5.21	0.39	4	0.45	0.65

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