Tseng Guan-Woei, Lin Mei-Chen, Lai Shih-Wei, Peng Cheng-Yuan, Chuang Po-Heng, Su Wen-Pang, Kao Jung-Ta, Lai Hsueh-Chou
Department of Medicine, China Medical University, Taichung 40402, Taiwan.
Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan.
World J Hepatol. 2021 Nov 27;13(11):1766-1776. doi: 10.4254/wjh.v13.i11.1766.
While primary liver cancer (PLC) is one of the most common cancers around the world, few large-scale population-based studies have been reported that evaluated the clinical survival outcomes among peripartum and postmenopausal women with PLC.
To investigate whether peripartum and postmenopausal women with PLC have lower overall survival rates compared with women who were not peripartum and postmenopausal.
The Taiwan National Health Insurance claims data from 2000 to 2012 was used for this propensity-score-matched study. A cohort of 40 peripartum women with PLC and a reference cohort of 160 women without peripartum were enrolled. In the women with PLC with/without menopause study, a study cohort of 10752 menopausal females with PLC and a comparison cohort of 2688 women without menopause were enrolled.
Patients with peripartum PLC had a non-significant risk of death compared with the non-peripartum cohort [adjusted hazard ratios (aHR) = 1.40, 95% confidence intervals (CI): 0.89-2.20, = 0.149]. The survival rate at different follow-up durations between peripartum PLC patients and those in the non-peripartum cohort showed a non-significant difference. Patients who were diagnosed with PLC younger than 50 years old (without menopause) had a significant lower risk of death compared with patients diagnosed with PLC at or older than 50 years (postmenopausal) (aHR = 0.64, 95%CI: 0.61-0.68, < 0.001). The survival rate of women < 50 years with PLC was significantly higher than older women with PLC when followed for 0.5 (72.44% 64.16%), 1 (60.57% 51.66%), 3 (42.92% 31.28%), and 5 year(s) (37.02% 21.83%), respectively ( < 0.001).
Peripartum females with PLC have no difference in survival rates compared with those patients without peripartum. Menopausal females with PLC have worse survival rates compared with those patients without menopause.
原发性肝癌（PLC）是全球最常见的癌症之一，但鲜有基于大规模人群的研究报告评估围产期和绝经后PLC女性的临床生存结局。
调查围产期和绝经后PLC女性的总生存率是否低于非围产期和绝经后的女性。
本倾向评分匹配研究使用了2000年至2012年台湾国民健康保险理赔数据。纳入了40名围产期PLC女性队列和160名非围产期女性对照队列。在有/无绝经的PLC女性研究中，纳入了10752名绝经后PLC女性研究队列和2688名未绝经女性对照队列。
与非围产期队列相比，围产期PLC患者的死亡风险无显著差异[调整后风险比（aHR）=1.40，95%置信区间（CI）：0.89 - 2.20，P = 0.149]。围产期PLC患者与非围产期队列在不同随访时间的生存率无显著差异。与50岁及以上（绝经后）诊断为PLC的患者相比，50岁以下（未绝经）诊断为PLC的患者死亡风险显著更低（aHR = 0.64，95%CI：0.61 - 0.68，P < 0.001）。PLC女性年龄<50岁时，随访0.5年（72.44%对64.16%）、1年（60.57%对51.66%）、3年（42.92%对31.28%）和5年（37.02%对21.83%）时的生存率显著高于年龄较大的PLC女性（P < 0.001）。
围产期PLC女性与非围产期患者的生存率无差异。绝经后PLC女性的生存率低于未绝经患者。
