Background: The prognosis of primary liver cancer (PLC) was influenced by death due to non-cancer causes, particularly death related to cardiovascular disease (CVD). This study aimed to analyze mortality of non-cancer causes and identify the independent risk factors associated with CVD-related deaths in PLC patients.
Methods: In total, 112140 patients were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database (2000-2019). Independent risk factors for death from CVD in patients with PLC were identified by Cox proportional hazards model.
Results: The median follow-up time of all PLC patients was 76 months (interquartile range (IQR): 36-129). The median overall survival (OS) was 12 months (IQR: 3-40). Patients with intrahepatic cholangiocarcinoma (ICC) had shorter OS than patients with hepatocellular carcinoma (HCC) (8 vs. 14 months; P < 0.001). A total of 87299 deaths were observed, among which 61477 (70.42 % of all deaths) were from PLC, and 12727 (14.58 % of all deaths) were from other cancers. Of all non-cancer deaths (9276, 10.63 %), 2860(30.86 %) were results of CVD. PLC patients had higher risks on CVD-related deaths, compared with general population (standard mortality ratio, SMR, 2.20; 95 % confidence interval, CI, 2.12-2.28). Typically, the highest SMRs appeared in the first year following cancer diagnosis. The multivariable analysis revealed the characteristics listed as followed to be independently risk factors of CVD: age, male (hazard ratio, HR: 1.248, 95%CI: 1.147-1.359), black race (HR: 1.334, 95%CI: 1.195-1.490), year 2016-2019 of diagnosis (HR 0.758, 95%CI: 0.671-0.856), ICC (HR: 1.202, 95%CI: 1.086-1.330), without surgery (HR: 2.479, 95%CI: 2.266-2.711) and without chemotherapy (HR: 2.211, 95%CI: 2.033-2.403).
Conclusion: It is essential to take cardiovascular health into consideration at the time of diagnosis for PLC patients as the risk of CVD mortality is significantly higher than that of general population.
© 2024 The Authors.