原发性肝癌新诊断时肺转移：一项基于人群的回顾性研究。

Pulmonary metastases in newly diagnosed hepatocellular carcinoma: a population-based retrospective study.

机构信息

Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Germany.

Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.

出版信息

HPB (Oxford). 2020 Sep;22(9):1295-1304. doi: 10.1016/j.hpb.2019.12.004. Epub 2019 Dec 28.

DOI:10.1016/j.hpb.2019.12.004

PMID:31892468

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) is a major form of primary liver cancer with steadily increasing incidence for the decades, and has propensity to have extrahepatic metastases, especially pulmonary metastases (PM). This study aimed to investigate temporal incidence trends, treatment, and survival of patients with HCCPM.

METHODS

Patients with HCCPM were retrospectively reviewed from 2010 to 2016 in US National Cancer Institute (NCI) Surveillance, Epidemiology, and End Results registry (SEER).

RESULTS

2242 patients with HCCPM were identified. Overall HCCPM incidence did not change from 2010 to 2016, with an annual percent change (APC) of 0.87% (95% CI = -2.50%-4.35%, P = 0.542). Similar incidence trends patterns were found in subgroup analyses of sex, age, and race. 1-year observed survival for HCCPM was 10.8% (95%CI = 8.9%-12.8%) and relative survival was 11.0% (95%CI = 9.1%-13.1%). Better outcomes were noted among patients who underwent liver-directed surgery, those who treated with chemotherapy, and those who received radiation.

CONCLUSIONS

The incidence of HCCPM does not increase with the increasing incidence of HCC. Patients with HCCPM have a dismal prognosis with low survival rates. Liver-directed surgery, use of chemotherapy, and radiation may be associated with improved outcomes.

摘要

背景

肝细胞癌（HCC）是原发性肝癌的主要形式，几十年来发病率稳步上升，且易发生肝外转移，尤其是肺转移（PM）。本研究旨在探讨 HCCPM 患者的时间发病趋势、治疗和生存情况。

方法

回顾性分析 2010 年至 2016 年美国国家癌症研究所（NCI）监测、流行病学和最终结果注册处（SEER）中 HCCPM 患者的资料。

结果

共确定了 2242 例 HCCPM 患者。2010 年至 2016 年，HCCPM 的总发病率没有变化，年变化百分比（APC）为 0.87%（95%CI=-2.50%-4.35%，P=0.542）。在性别、年龄和种族的亚组分析中，也发现了相似的发病趋势模式。HCCPM 的 1 年观察生存率为 10.8%（95%CI=8.9%-12.8%），相对生存率为 11.0%（95%CI=9.1%-13.1%）。接受肝定向手术、化疗和放疗的患者预后较好。