Effect of prior cancer on survival of hepatocellular carcinoma: implications for clinical trial eligibility criteria
Abstract Background Patients with cancer history are usually excluded from hepatocellular carcinoma (HCC) clinical trials. However, whether previous malignancy affects the oncological outcomes of HCC patients has not been fully assessed. This study aimed to evaluate whether prior cancer compromised...
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doaj-126f3e0dc9db4c2888bdb5ffcf08f5b52021-02-14T12:48:41ZengBMCBMC Cancer1471-24072021-02-012111910.1186/s12885-021-07870-0Effect of prior cancer on survival of hepatocellular carcinoma: implications for clinical trial eligibility criteriaXuqi Sun0Lingling Li1Li Xu2Zhongguo Zhou3Jinbin Chen4Juncheng Wang5Yaojun Zhang6Dandan Hu7Minshan Chen8State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer CenterZhongshan School of Medicine, Sun Yat-Sen UniversityState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer CenterAbstract Background Patients with cancer history are usually excluded from hepatocellular carcinoma (HCC) clinical trials. However, whether previous malignancy affects the oncological outcomes of HCC patients has not been fully assessed. This study aimed to evaluate whether prior cancer compromised the survival of HCC patients. Methods Patients with HCC were extracted from the Surveillance, Epidemiology, and End Results database between 2004 and 2015, and then they were classified into groups with and without prior cancer. The Kaplan-Meier and multivariate Cox regression analysis were adopted to evaluate whether prior cancer impacted clinical outcomes after propensity score matching (PSM) adjusting baseline differences. Validation was performed in the cohort from our institution. Results We identified 2642 HCC patients with prior cancer. After PSM, the median overall survival (OS) time were 14.5 and 12.0 months respectively for groups with and without prior cancer. Prior cancer did not compromise prognosis in patients with HCC (p = 0.49). The same tendency was found in subgroups stratified by tumor stages and cancer interval period: OS was similar between groups with and without prior cancer (both p values> 0.1). In the multivariate Cox regression model, prior cancer did not adversely impact patients’ survival (HR: 1.024; 95% CI: 0.961–1.092). In the validation cohort from our institution, prior cancer had no significant association with worse outcomes (p = 0.48). Conclusion For HCC patients, prior cancer did not compromise their survival, regardless of tumor stage and cancer interval period. Exclusion criteria for HCC clinical trials could be reconsidered.https://doi.org/10.1186/s12885-021-07870-0Hepatocellular carcinomaPrior cancerSurvivalClinical trials |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xuqi Sun Lingling Li Li Xu Zhongguo Zhou Jinbin Chen Juncheng Wang Yaojun Zhang Dandan Hu Minshan Chen |
spellingShingle |
Xuqi Sun Lingling Li Li Xu Zhongguo Zhou Jinbin Chen Juncheng Wang Yaojun Zhang Dandan Hu Minshan Chen Effect of prior cancer on survival of hepatocellular carcinoma: implications for clinical trial eligibility criteria BMC Cancer Hepatocellular carcinoma Prior cancer Survival Clinical trials |
author_facet |
Xuqi Sun Lingling Li Li Xu Zhongguo Zhou Jinbin Chen Juncheng Wang Yaojun Zhang Dandan Hu Minshan Chen |
author_sort |
Xuqi Sun |
title |
Effect of prior cancer on survival of hepatocellular carcinoma: implications for clinical trial eligibility criteria |
title_short |
Effect of prior cancer on survival of hepatocellular carcinoma: implications for clinical trial eligibility criteria |
title_full |
Effect of prior cancer on survival of hepatocellular carcinoma: implications for clinical trial eligibility criteria |
title_fullStr |
Effect of prior cancer on survival of hepatocellular carcinoma: implications for clinical trial eligibility criteria |
title_full_unstemmed |
Effect of prior cancer on survival of hepatocellular carcinoma: implications for clinical trial eligibility criteria |
title_sort |
effect of prior cancer on survival of hepatocellular carcinoma: implications for clinical trial eligibility criteria |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2021-02-01 |
description |
Abstract Background Patients with cancer history are usually excluded from hepatocellular carcinoma (HCC) clinical trials. However, whether previous malignancy affects the oncological outcomes of HCC patients has not been fully assessed. This study aimed to evaluate whether prior cancer compromised the survival of HCC patients. Methods Patients with HCC were extracted from the Surveillance, Epidemiology, and End Results database between 2004 and 2015, and then they were classified into groups with and without prior cancer. The Kaplan-Meier and multivariate Cox regression analysis were adopted to evaluate whether prior cancer impacted clinical outcomes after propensity score matching (PSM) adjusting baseline differences. Validation was performed in the cohort from our institution. Results We identified 2642 HCC patients with prior cancer. After PSM, the median overall survival (OS) time were 14.5 and 12.0 months respectively for groups with and without prior cancer. Prior cancer did not compromise prognosis in patients with HCC (p = 0.49). The same tendency was found in subgroups stratified by tumor stages and cancer interval period: OS was similar between groups with and without prior cancer (both p values> 0.1). In the multivariate Cox regression model, prior cancer did not adversely impact patients’ survival (HR: 1.024; 95% CI: 0.961–1.092). In the validation cohort from our institution, prior cancer had no significant association with worse outcomes (p = 0.48). Conclusion For HCC patients, prior cancer did not compromise their survival, regardless of tumor stage and cancer interval period. Exclusion criteria for HCC clinical trials could be reconsidered. |
topic |
Hepatocellular carcinoma Prior cancer Survival Clinical trials |
url |
https://doi.org/10.1186/s12885-021-07870-0 |
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