title: Clinical features and outcome of multiple primary malignancies involving hepatocellular carcinoma: a long-term follow-up study.
abstract: BACKGROUND
  The prolonged survival of individuals diagnosed with cancer has led to an increase in the number of secondary primary malignancies. We undertook to perform a definitive study to characterize and predict prognosis of multiple primary malignancies (MPM) involving hepatocellular carcinoma (HCC), due to the scarcity of such reports.
  
  
  METHODS
  Clinicopathological data were analyzed for 68 MPM patients involving HCC, with 35 (target group) underwent curative liver resection. Additional 140 HCC-alone patients with hepatectomy were selected randomly during the same period as the control group.
  
  
  RESULTS
  Of the 68 patients with extrahepatic primary malignancies (EHPM), 22 were diagnosed synchronously with HCC, and 46 metachronously. The most frequent EHPM was nasophageal carcinoma, followed by colorectal and lung cancer. Univariate analysis demonstrated that synchronous (P = 0.008) and non-radical treatment for EHPM (P < 0.001) were significant risk factors associated with poorer overall survival (OS). While, Cox modeling revealed that the treatment modality for EHPM, but not the synchronous/metachronous determinant, was an independent factor for OS, and that therapeutic option for HCC was an independent factor for HCC-specific OS. Moreover, no HCC-specific overall and recurrence-free survival benefit were observed in the control group when compared with that of the target group (P = 0.607, P = 0.131, respectively).
  
  
  CONCLUSIONS
  Curative treatment is an independent predictive factor for OS and HCC-specific OS, and should been taken into account both for synchronous and metachronous patients. MPM patients involving HCC should not be excluded from radical resection for HCC.
authors.affiliation: State Key Laboratory of Oncology in South China/Department of Hepatobiliary Oncology, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, Guangdong, China.
authors.forename: Qing-An
authors.initials: QA
authors.lastname: Zeng
authors.forename: Jiliang
authors.initials: J
authors.lastname: Qiu
authors.forename: Ruhai
authors.initials: R
authors.lastname: Zou
authors.forename: Yijie
authors.initials: Y
authors.lastname: Li
authors.forename: Shengping
authors.initials: S
authors.lastname: Li
authors.forename: Binkui
authors.initials: B
authors.lastname: Li
authors.forename: Pinzhu
authors.initials: P
authors.lastname: Huang
authors.forename: Jian
authors.initials: J
authors.lastname: Hong
authors.forename: Yun
authors.initials: Y
authors.lastname: Zheng
authors.forename: Xiangming
authors.initials: X
authors.lastname: Lao
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome