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Updated: Jun 11, 2025
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Survival and cardiovascular disease mortality among primary liver cancer patients: A population-based study
Lidong Wang1, Ting Wang1, Wu Zhang1
1The Department of Hepatobiliary and Pancreatic Surgery, Shulan (Hangzhou) Hospital Affiliated to Zhejiang Shuren University Shulan International Medical College, Hangzhou, Zhejiang, PR China.
Background:
The prognosis of primary liver cancer (PLC) was influenced by death due to non-cancer causes, particularly death related to cardiovascular disease (CVD). This study aimed to analyze mortality of non-cancer causes and identify the independent risk factors associated with CVD-related deaths in PLC patients.
Methods:
In total, 112140 patients were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database (2000-2019). Independent risk factors for death from CVD in patients with PLC were identified by Cox proportional hazards model.
Results:
The median follow-up time of all PLC patients was 76 months (interquartile range (IQR): 36-129). The median overall survival (OS) was 12 months (IQR: 3-40). Patients with intrahepatic cholangiocarcinoma (ICC) had shorter OS than patients with hepatocellular carcinoma (HCC) (8 vs. 14 months; P < 0.001). A total of 87299 deaths were observed, among which 61477 (70.42 % of all deaths) were from PLC, and 12727 (14.58 % of all deaths) were from other cancers. Of all non-cancer deaths (9276, 10.63 %), 2860(30.86 %) were results of CVD. PLC patients had higher risks on CVD-related deaths, compared with general population (standard mortality ratio, SMR, 2.20; 95 % confidence interval, CI, 2.12-2.28). Typically, the highest SMRs appeared in the first year following cancer diagnosis. The multivariable analysis revealed the characteristics listed as followed to be independently risk factors of CVD: age, male (hazard ratio, HR: 1.248, 95%CI: 1.147-1.359), black race (HR: 1.334, 95%CI: 1.195-1.490), year 2016-2019 of diagnosis (HR 0.758, 95%CI: 0.671-0.856), ICC (HR: 1.202, 95%CI: 1.086-1.330), without surgery (HR: 2.479, 95%CI: 2.266-2.711) and without chemotherapy (HR: 2.211, 95%CI: 2.033-2.403).
Conclusion:
It is essential to take cardiovascular health into consideration at the time of diagnosis for PLC patients as the risk of CVD mortality is significantly higher than that of general population.
