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Second primary cancers in patients with hepatocellular carcinoma: a nationwide cohort study in Taiwan
Author(s) -
Wu WenChieh,
Chen YungTai,
Hwang ChianYaw,
Su ChienWei,
Li SzuYuan,
Chen TzengJi,
Liu ChiaJen,
Kao WeiYu,
Chao Yee,
Lin HanChieh,
Wu JawChing
Publication year - 2013
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12103
Subject(s) - medicine , incidence (geometry) , hepatocellular carcinoma , cancer , kidney disease , kidney cancer , bladder cancer , cohort , population , cancer registry , cohort study , oncology , gastroenterology , environmental health , physics , optics
Background There has been no large‐scale population‐based study on the incidence and clinical manifestations of second primary cancer ( SPC ) after diagnosis of hepatocellular carcinoma ( HCC ). Aims This study aimed to evaluate the incidence and the risk factors of SPC following HCC diagnosis. Method This study used data from the National Health Insurance Research Database of Taiwan to identify all HCC patients from 1 January 1997 to 31 December 2006. Cases of SPC were gathered using the ICD 9‐ CM codes of 140–208.91. Standardized incidence ratios ( SIR s) were conducted for incidence of SPC in HCC survivors. Competing‐risks regression with adjustment of death was used to analyse the risk factors of SPC . Results From 45 976 HCC patients, 749 (1.6%) developed SPC after 90 days of HCC diagnosis. Male HCC patients had higher risks of gastric, biliary, urinary bladder, kidney and haematological cancers compared to the general male population. Female patients had higher incidences of biliary tract, kidney and bone and soft tissue cancers. Older age and chronic kidney disease ( CKD ) were independent factors predicting SPC . Conclusions SPC in patients with HCC is not rare in Taiwan. Urinary bladder cancer and renal cancer are more specific SPC for HCC patients. Better surveillance strategies for SPC should be established for HCC survivors, especially in the elderly or those with CKD .