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. 2021 May 10:11:652768.
doi: 10.3389/fonc.2021.652768. eCollection 2021.

Correlation and Survival Analysis of Distant Metastasis Site and Prognosis in Patients With Hepatocellular Carcinoma

Hao Zhan  1 , Xue Zhao  1 , Zhaoxue Lu  1 , Yuanhu Yao  1 , Xuguang Zhang  1   2
Affiliations

Correlation and Survival Analysis of Distant Metastasis Site and Prognosis in Patients With Hepatocellular Carcinoma

Hao Zhan et al. Front Oncol. .

Abstract

Purpose: To investigate the prognostic factors and survival analysis of patients with hepatocellular carcinoma with distant metastasis.

Methods: The clinical data of 3,126 patients with distant metastasis of hepatocellular carcinoma from 2010 to 2015 were extracted from SEER database, and the correlation between the location of distant metastasis of hepatocellular carcinoma and prognosis was retrospectively analyzed. Patients were grouped according to different metastatic sites. The clinical characteristics of each group were compared by chi-square test, the survival curve was drawn by Kaplan-Meier method, Log-rank test was used for univariate analysis, and Cox regression for multivariate analysis. And use propensity score matching (PSM) to reduce differences in baseline characteristics.

Results: Before PSM, the prognosis of patients with hepatocellular carcinoma with lung metastasis is worse than that of patients without lung metastasis. And there was no statistically significant difference with or without bone metastases.Patients with one type of organ metastasis had better prognosis than those with multiple organ metastasis. Among patients with organ metastasis, bone metastasis has a better prognosis than patients with lung metastasis. After PSM, patients with HCC with bone metastases had a worse prognosis than those without bone metastases (P<0.05). Univariate analysis showed that the degree of tumor differentiation, T stage, N stage, primary tumor and metastatic surgery, radiotherapy and chemotherapy, tumor size, single organ metastasis, the number of metastatic organs, and the combination of metastatic organs were related to the prognosis of patients with distant metastasis of hepatocellular carcinoma (P < 0.05). Multiariate analysis showed that age ≥52 years old, male, low degree of tumor differentiation, N1 stage, no primary surgery, no chemoradiotherapy, tumor size > 6cm, and multi-organ metastasis were independent influencing factors for poor prognosis in patients with metastatic hepatocellular carcinoma.

Conclusion: The lung is the most common site of distant metastasis of hepatocellular carcinoma. Single organ metastasis has better prognosis than multiple organ metastasis. Age ≥52 years old, male, low degree of tumor differentiation, N1 stage, no primary surgery, no chemoradiotherapy, tumor size > 6cm, and multi-organ metastasis were independent influencing factors for poor overall survival and cancer-specific survival prognosis in patients with metastatic hepatocellular carcinoma.

Keywords: SEER database; distant metastasis; hepatocellular carcinoma; prognosis; survival analysis.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Selection of the best cut-off point for Age and tumor size. (A, C) Histogram showing the best cut-off point; (B, D) Keplan-Meier curve corresponding to the cut-off point.
Figure 2
Figure 2
Overall survival and cancer-specific survival curves with or without corresponding organ metastasis. (A, B) lung metastasis; (C, D) bone metastasis; (E, F) brain metastasis.
Figure 3
Figure 3
(A) Overall survival and (B) Cancer-specific survival curves of patients with different metastatic organ numbers.
Figure 4
Figure 4
(A) Overall survival and (B) cancer-specific survival curves of different metastatic sites in a patient with single organ metastasis.
Figure 5
Figure 5
Overall survival and cancer-specific survival curves of primary tumors and metastatic tumors in all patients with organ metastasis. (A, B) Primary tumor surgery; (C, D) Metastatic surgery.
Figure 6
Figure 6
Overall survival and cancer-specific survival curves with or without corresponding organ metastasis after PSM. (A, B) Bone metastasis; (C, D) Brain metastasis; (E, F) Lung metastasis.
Figure 7
Figure 7
(A) Overall survival and (B) cancer-specific survival curves of patients with different numbers of metastatic organs after PSM.
See this image and copyright information in PMC

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