Trends in Incidence and Prognostic Factors of Two Subtypes of Primary Liver Cancers: A Surveillance, Epidemiology, and End Results-Based Population Study

• Published in: Cancer control Vol. 29; p. 10732748211051548
• Main Authors: Yao, Jiping, Liang, Xue, Liu, Yanning, Li, Shuangshuang, Zheng, Min
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 07-02-2022; Sage Publications Ltd; SAGE Publishing
• Subjects: Adenomatous polyposis coli; Bile Duct Neoplasms - epidemiology; Bile Duct Neoplasms - therapy; Bile Ducts, Intrahepatic; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - therapy; Chemotherapy; Cholangiocarcinoma; Diagnosis; Epidemiology; Hepatocellular carcinoma; Humans; Incidence; Liver cancer; Liver Neoplasms - epidemiology; Liver Neoplasms - therapy; Lymph nodes; Male; Medical prognosis; Original; Population studies; Prognosis; Races; SEER Program; Surgery; Surveillance; Survival; United States - epidemiology; United States; prediction; incidence; prognosis; hepatocellular carcinoma; intrahepatic cholangiocarcinoma
• ISSN: 1073-2748; 1526-2359; 1073-2748
• DOI: 10.1177/10732748211051548

Objectives
The objective of our study was to investigate and compare the epidemiologic characteristics, prognostic factors, and survival between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) patients.
Methods
Age-adjusted incidence rates were evaluated from 1975 to 2016 using the Surveillance, Epidemiology, and End Results (SEER) database. Overall survival (OS) was investigated using the Kaplan–Meier method and log-rank test. Univariate and multivariate Cox regression analyses were performed to identify the independent prognostic factors for OS.
Results
In the last 10 years, the incidence rate of ICC increased rapidly by 109% (annual percentage change (APC) = 8.24, 95% CI = 6.64 to 9.86; P < .001), compared with a much more modest 12% increase in the incidence of HCC (APC = 1.59, 95% CI = .56 to 2.62; P < .001). This trend persisted throughout the study across different age groups, sexes, and races. Males older than 70 years and of other races (non-African American and non-Caucasian) showed the highest incidence rates of HCC and ICC. Multivariate Cox regression analysis demonstrated that other race, married status, later year of diagnosis, more examined lymph nodes, and surgery were significant protective factors of OS in HCC patients. In contrast, the race and year of diagnosis were not independent prognostic factors, but radiation and chemotherapy were protective factors of OS in ICC patients. The median OS was 18 months and 12 months in HCC and ICC patients, respectively.
Conclusion
In the last 10 years, the incidence of HCC had a slow growth in the United States, whereas ICC showed a remarkable increase. The 5-year OS of the former has improved in recent years while that of the latter showed no significant improvement. Therefore, surgery could contribute to superior survival outcomes as compared to other treatments.