Does fibrosis have an impact on survival of patients with hepatocellular carcinoma: evidence from the SEER database?

doi:10.1186/s12885-018-4996-z

. 2018 Nov 16;18(1):1125.

doi: 10.1186/s12885-018-4996-z.

Does fibrosis have an impact on survival of patients with hepatocellular carcinoma: evidence from the SEER database?

Hui Liu¹, Dong Cen², Yunxian Yu³, Yanting Wang⁴, Xiao Liang², Hui Lin², Xiujun Cai^{5

6}

Affiliations

¹ Zhejiang Provincial Key Laboratory of Laparoscopic Technology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
² Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
³ Department of Epidemiology and Health Statistics, School of Medicine, Zhejiang University, Hangzhou, China.
⁴ Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL, USA.
⁵ Zhejiang Provincial Key Laboratory of Laparoscopic Technology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China. srrsh_cxj@zju.edu.cn.
⁶ Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China. srrsh_cxj@zju.edu.cn.

PMID: 30445928
PMCID: PMC6240175
DOI: 10.1186/s12885-018-4996-z

Does fibrosis have an impact on survival of patients with hepatocellular carcinoma: evidence from the SEER database?

Hui Liu et al. BMC Cancer. 2018.

. 2018 Nov 16;18(1):1125.

doi: 10.1186/s12885-018-4996-z.

Authors

Hui Liu¹, Dong Cen², Yunxian Yu³, Yanting Wang⁴, Xiao Liang², Hui Lin², Xiujun Cai^{5

6}

Affiliations

¹ Zhejiang Provincial Key Laboratory of Laparoscopic Technology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
² Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
³ Department of Epidemiology and Health Statistics, School of Medicine, Zhejiang University, Hangzhou, China.
⁴ Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, IL, USA.
⁵ Zhejiang Provincial Key Laboratory of Laparoscopic Technology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China. srrsh_cxj@zju.edu.cn.
⁶ Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China. srrsh_cxj@zju.edu.cn.

PMID: 30445928
PMCID: PMC6240175
DOI: 10.1186/s12885-018-4996-z

Abstract

Background: Liver fibrosis is involved in hepatocellular carcinoma (HCC), but its effect on the survival of patients with HCC remains controversial. This study aims to explore whether the severity of liver fibrosis has an impact on HCC overall survival (OS) and disease-specific survival (DSS) in Surveilance, Epidemiology, and End-Results (SEER) database.

Methods: A total of 11,783 HCC patients diagnosed between 2004 and 2014 from SEER database were enrolled. Cox proportional hazard regression models were used to estimate crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for fibrosis group associated with survival. Decision curve analysis (DCA) was also performed to compare the effect of fibrosis with other clinicopathological characteristics for survival outcome.

Results: Patients with high fibrosis score (5-6) had a greater proportion than those with low fibrosis score (0-4) (80.3% vs. 19.7%). Fibrosis score was an independent prognostic factor for OS (HR = 1.09, 95%CI: 1.02-1.16), but not for DSS (HR = 1.05, 95%CI: 0.98-1.13) by multivariate Cox proportional hazard models. Additionally, there was no significant effect of liver fibrosis on OS and DSS with stratification of TNM stage and therapy. Findings of DCA showed that fibrosis was less associated with survival outcome in comparison with other tumor characteristics.

Conclusions: The effect of fibrosis on HCC survival was less important than that of other clinicopathological characteristics (like TNM stage or tumor size).

Keywords: Decision curve analysis; Hepatocellular carcinoma; Liver fibrosis; SEER database; Survival.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The data in this study was obtained from SEER database and National Cancer Institute had given us permission to access data for researching (Reference number: 11114-Nov2016). Given that SEER data is de-identified and ethics approval is waived, this study was exempted from Institutional Research Board review.

Consent for publication

Not applicable.

Competing interests

The authors declare that we have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

**Fig. 1**
Flowchart displaying the selection procedure of HCC cases in SEER database

**Fig. 2**
Decision curve analysis of fibrosis in patients with HCC. a The net benefit plotted using fibrosis, TNM stage, tumor size for overall survival. b The net benefit plotted using fibrosis, TNM stage, tumor size for disease-specific survival. c The net benefit plotted using multivariate models with and without fibrosis for overall survival

See this image and copyright information in PMC

Cited by

Risk factors and predictive nomograms for early death of patients with advanced hepatocellular carcinoma: a large retrospective study based on the SEER database.
Zhang H, Du X, Dong H, Xu W, Zhou P, Liu S, Qing X, Zhang Y, Yang M, Zhang Y. Zhang H, et al. BMC Gastroenterol. 2022 Jul 19;22(1):348. doi: 10.1186/s12876-022-02424-5. BMC Gastroenterol. 2022. PMID: 35854221 Free PMC article.
Development and Identification of a Nomogram Prognostic Model for Patients with Primary Clear Cell Carcinoma of the Liver.
Zhang Z, Xie H, Chen P, Cao P. Zhang Z, et al. Med Sci Monit. 2020 Jan 23;26:e919789. doi: 10.12659/MSM.919789. Med Sci Monit. 2020. PMID: 31969554 Free PMC article.
Impact of liver fibrosis score on prognosis after common therapies for intrahepatic cholangiocarcinoma: a propensity score matching analysis.
Zhang JX, Li P, Chen Z, Lin H, Cai Z, Liao W, Pan Z. Zhang JX, et al. BMC Cancer. 2020 Jun 15;20(1):556. doi: 10.1186/s12885-020-07051-5. BMC Cancer. 2020. PMID: 32539768 Free PMC article.
Risk scoring based on expression of long non‑coding RNAs can effectively predict survival in hepatocellular carcinoma patients with or without fibrosis.
Ye J, Wu S, Pan S, Huang J, Ge L. Ye J, et al. Oncol Rep. 2020 May;43(5):1451-1466. doi: 10.3892/or.2020.7528. Epub 2020 Feb 18. Oncol Rep. 2020. PMID: 32323856 Free PMC article.
Lymphoepithelial carcinoma of the oral cavity and pharynx: a SEER population-based cohort study.
Bai J, Zhao F, Zhang W, Zheng P, Pan S. Bai J, et al. Am J Transl Res. 2023 Apr 15;15(4):2716-2726. eCollection 2023. Am J Transl Res. 2023. PMID: 37193188 Free PMC article.

See all "Cited by" articles

References

1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90. doi: 10.3322/caac.20107. - DOI - PubMed
1. Mittal S, El-Serag HB. Epidemiology of hepatocellular carcinoma: consider the population. J Clin Gastroenterol. 2013;47(Suppl):S2–S6. doi: 10.1097/MCG.0b013e3182872f29. - DOI - PMC - PubMed
1. Maluccio M, Covey A. Recent progress in understanding, diagnosing, and treating hepatocellular carcinoma. CA Cancer J Clin. 2012;62(6):394–399. doi: 10.3322/caac.21161. - DOI - PubMed
1. Njei B, Rotman Y, Ditah I, Lim JK. Emerging trends in hepatocellular carcinoma incidence and mortality. Hepatology (Baltimore, Md) 2015;61(1):191–199. doi: 10.1002/hep.27388. - DOI - PMC - PubMed
1. Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, de Oliveira AC, Santoro A, Raoul JL, Forner A, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359(4):378–390. doi: 10.1056/NEJMoa0708857. - DOI - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LQ17H260001/Natural Science Foundation of Zhejiang Province

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

[1] Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90. doi: 10.3322/caac.20107. - DOI - PubMed

[2] Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90. doi: 10.3322/caac.20107. - DOI - PubMed

[3] Mittal S, El-Serag HB. Epidemiology of hepatocellular carcinoma: consider the population. J Clin Gastroenterol. 2013;47(Suppl):S2–S6. doi: 10.1097/MCG.0b013e3182872f29. - DOI - PMC - PubMed

[4] Mittal S, El-Serag HB. Epidemiology of hepatocellular carcinoma: consider the population. J Clin Gastroenterol. 2013;47(Suppl):S2–S6. doi: 10.1097/MCG.0b013e3182872f29. - DOI - PMC - PubMed

[5] Maluccio M, Covey A. Recent progress in understanding, diagnosing, and treating hepatocellular carcinoma. CA Cancer J Clin. 2012;62(6):394–399. doi: 10.3322/caac.21161. - DOI - PubMed

[6] Maluccio M, Covey A. Recent progress in understanding, diagnosing, and treating hepatocellular carcinoma. CA Cancer J Clin. 2012;62(6):394–399. doi: 10.3322/caac.21161. - DOI - PubMed

[7] Njei B, Rotman Y, Ditah I, Lim JK. Emerging trends in hepatocellular carcinoma incidence and mortality. Hepatology (Baltimore, Md) 2015;61(1):191–199. doi: 10.1002/hep.27388. - DOI - PMC - PubMed

[8] Njei B, Rotman Y, Ditah I, Lim JK. Emerging trends in hepatocellular carcinoma incidence and mortality. Hepatology (Baltimore, Md) 2015;61(1):191–199. doi: 10.1002/hep.27388. - DOI - PMC - PubMed

[9] Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, de Oliveira AC, Santoro A, Raoul JL, Forner A, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359(4):378–390. doi: 10.1056/NEJMoa0708857. - DOI - PubMed

[10] Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, de Oliveira AC, Santoro A, Raoul JL, Forner A, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359(4):378–390. doi: 10.1056/NEJMoa0708857. - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Does fibrosis have an impact on survival of patients with hepatocellular carcinoma: evidence from the SEER database?

Affiliations

Does fibrosis have an impact on survival of patients with hepatocellular carcinoma: evidence from the SEER database?

Authors

Affiliations

Abstract

Conflict of interest statement

Ethics approval and consent to participate

Consent for publication

Competing interests

Publisher’s Note

Figures

Similar articles

Cited by

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical