ArticleFrontiers in oncology2021
Second Primary Malignancies in Patients With Hepatocellular Carcinoma: A Population-Based Analysis.
Article in Frontiers in oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 11 citations in OpenAlex.
- Chronic liver disease and radiation-induced second primary liver malignancy: a retrospective cohort based on SEER database 2010-2021.Annals of medicine and surgery (2012) · 2025Article
- Risk prediction of second primary malignancies in patients with primary gastric neuroendocrine neoplasms: a population-based study.Discover oncology · 2025Article
- Risk-based screening and prognostic analysis for second primary malignancies in kidney cancer patients: a retrospective cohort study based on large-scale population and Mendelian randomization analysis.International journal of medical sciences · 2025Article
- The impact of single and multiple occurrences, as well as the sequence of occurrences, of primary gastrointestinal cancer on overall survival: a comprehensive analysis based on the surveillance, epidemiology, and end results database in the United States from 2016 to 2019.Archives of public health = Archives belges de sante publique · 2024Article
- Incidence, risk and prognosis of second primary malignancy of patients with gastric adenocarcinoma.Scientific reports · 2024Article
- Risk, molecular subtype and prognosis of second primary breast cancer: an analysis based on first primary cancers.American journal of cancer research · 2023Article
- Immune Activation, Exhaustion and Senescence Profiles as Possible Predictors of Cancer in Liver Transplanted Patients.Frontiers in oncology · 2022Article
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSecond primary malignancy (SPM) is becoming a threat for the health of cancer survivors. However, data on the features and results of patients with hepatocellular carcinoma (HCC) with SPMs are scarce. This study aimed to explore the characteristics of HCC patients with SPMs and to screen HCC patients who are at a high risk of developing SPMs.
methodHCC patients diagnosed between 2000 and 2014 in the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively analyzed. Eligible patients were divided into the only one primary malignancy and SPM groups. The Fine-Gray proportional subdistribution hazards model was used to explore the risk factors of developing SPMs, and a competing-risk model was established to predict the probability of developing SPMs for HCC patients after initial diagnosis. The calibration curves, concordance index (C-index), and decision curve analysis (DCA) were used to evaluate the performance of the nomogram.
resultsA total of 40,314 HCC patients were identified, 1,593 (3.95%) of whom developed SPMs 2 months after the initial diagnosis with a maximum follow-up time of approximately 18 years. The 3-, 5-, and 10-year cumulative incidence of SPMs were 2.35%, 3.12%, and 4.51%, respectively. Age at initial diagnosis, extent of disease, tumor size, and treatment were identified as the independent risk factors of developing SPMs and integrated into the competing-risk nomogram. The C-index of the nomogram was 0.677 (95% confidence interval 0.676-0.678), and the calibration curves showed an excellent agreement between the nomogram prediction and the actual observations. Furthermore, DCA indicated that the nomogram had good net benefits in clinical scenarios.
conclusionsHCC survivors remain at a high risk of developing SPMs. The development of SPMs was associated with the clinical features and treatment strategies. A competing-risk nomogram was constructed to help surgeons identify the patients who are at a high risk of developing SPMs and contribute to the further management of SPMs.
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