Department of Hepatopancreatobiliary Surgery, Qingdao Municipal Hospital, Qingdao University, Qingdao, People's Republic of China.
Department of Hepatopancreatobiliary Surgery, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, People's Republic of China.
Cancer Med. 2023 Jun;12(12):13076-13085. doi: 10.1002/cam4.5986. Epub 2023 Apr 21.
The gains in survival outcomes of US patients with hepatocellular carcinoma (HCC) have come at the expense of developing non-cancer-related morbidities, such as cardiovascular diseases (CVDs) and infections. However, population-based data on causes of death (CODs) in patients with HCC are scarce.
A cancer registry database in the United States was used to analyze the CODs among patients with HCC. Death cause distribution and standardized mortality ratios were calculated to quantify the disease-specific death burden.
A total of 40,094 patients with a histological diagnosis of HCC were identified from the SEER-18 database between 2000 and 2018, of which 30,796 (76.8%) died during the follow-up period. The majority of these deaths (25,153, 81.7%) occurred within 2 years after diagnosis, 13.2% (4075) occurred within 2-5 years, and 5.1% (1568) occurred after 5 years. All age groups had a lower burden of female deaths than of male deaths during the study period. With respect to CODs, 23,824 (77.4%), 2289 (7.4%), and 4683 (15.2%) were due to HCC, other cancers, and non-cancer causes, respectively. Non-cancer-related deaths were more common among older patients and those with longer latency periods since diagnosis. The major causes of non-cancer-related deaths are other infectious and parasitic diseases, including HIV and CVDs.
CODs during HCC survivorship varied, and a growing number of survivors tended to die from causes other than HCC, with an increasing latency period since diagnosis. Comprehensive analyses of mortality patterns and temporal trends could underpin strategies to reduce these risks.
美国肝细胞癌 (HCC) 患者的生存获益是以发生非癌症相关的发病率为代价的，例如心血管疾病 (CVD) 和感染。然而，关于 HCC 患者死亡原因 (CODs) 的人群数据却很少。
使用美国癌症登记数据库分析 HCC 患者的 CODs。计算死亡原因分布和标准化死亡率比，以量化特定疾病的死亡负担。
从 SEER-18 数据库中确定了 2000 年至 2018 年间共 40094 例经组织学诊断为 HCC 的患者，其中 30796 例（76.8%）在随访期间死亡。这些死亡患者中，大多数（25153 例，81.7%）在诊断后 2 年内死亡，13.2%（4075 例）在 2-5 年内死亡，5.1%（1568 例）在 5 年后死亡。在研究期间，所有年龄组的女性死亡负担均低于男性。就 CODs 而言，分别有 23824 例（77.4%）、2289 例（7.4%）和 4683 例（15.2%）归因于 HCC、其他癌症和非癌症原因。非癌症相关死亡在老年患者和诊断后潜伏期较长的患者中更为常见。非癌症相关死亡的主要原因是其他传染性和寄生虫病，包括 HIV 和 CVD。
HCC 生存期间的 CODs 各不相同，越来越多的幸存者倾向于死于非 HCC 原因，且自诊断后的潜伏期逐渐延长。对死亡率模式和时间趋势的综合分析可以为降低这些风险的策略提供依据。
