Clinical manifestations between hepatocellular carcinoma (HCC) and extra-hepatic primary malignancy (EHPM) are lack of large-scale study. We enrolled 14555 HCC patients between 1986 and 2013 retrospectively. The EHPM was classified as prior, synchronous and metachronous group based on before, within and after 6 months of HCC diagnosis, respectively. The incidence rate of EHPM is 3.91% (95% confidence interval [CI]: 3.60–4.23%). Urogenital cancers, kidney and bladder, were at unexpected higher ranks. Older in age, Child-Pugh A cirrhosis, negativity of HBsAg and anti-HCV, and earlier BCLC staging are independent factors associated with EHPM. The survival rates of EHPM improve over time and also better than HCC-alone. Cox proportional-hazards regression shows independent poor prognostic factors are age >60, male, AFP levels ≥400 ng/ml, positivity of HBsAg, Child-Pugh B vs. A, Non-metachronous group, respectively, treated with local ablation, transcatheter arterial embolization, radiotherapy and supportive care vs. surgery, respectively, TNM stage IIIA vs. I, and BCLC stages A, B, C and D vs. 0, respectively. Survival of EHPM improve could be explained by early diagnosis and improve treatment of cancers.
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机译：肝细胞癌（HCC）和肝外原发性恶性肿瘤（EHPM）之间的临床表现尚缺乏大规模研究。我们回顾性研究了1986年至2013年之间的14555例HCC患者。根据HCC诊断的6个月之前，之内和之后，EHPM分为先行，同步和异时组。 EHPM的发生率为3.91％（95％置信区间[CI]：3.60–4.23％）。泌尿生殖系统癌症（肾脏和膀胱癌）的出乎意料的更高。年龄较大，Child-Pugh A肝硬化，HBsAg和抗HCV阴性，早期BCLC分期是与EHPM相关的独立因素。随着时间的推移，EHPM的生存率提高，并且也比单纯HCC更好。 Cox比例风险回归显示独立的不良预后因素为年龄> 60岁，男性，AFP水平≥400ng / ml，HBsAg阳性，Child-Pugh B vs. A，非同步组，分别采用局部消融，经导管治疗动脉栓塞，放疗和支持治疗与手术分别为，TNM IIIA阶段与I阶段以及BCLC A，B，C和D阶段与0阶段相对。 EHPM存活率提高可以通过早期诊断和改善癌症治疗来解释。
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