Liver cancer is the sixth most common cancer and third most common cause of cancer-related deaths in the world. A total of 782,000 new cases diagnosed in 2012 worldwide. Hepatocellular carcinoma (HCC) is the most common form of liver cancer. In Taiwan, HCC is the top two leading cause of cancer mortality. In the past, the overall survival of HCC is poor because majority of the patients are diagnosed at late stage. Surveillance by abdominal ultrasound and alpha-fetoprotein in high-risk groups could identify patients in early stage. The median survival of HCC patients improves in recent years and could be up to 60 months in early stage. Because of the improvement in the survival of cancer patients, second primary cancer becomes an important issue to overcome. In USA, around 18% of all incident cancers was detected in cancer survivors. European study also showed increased incidence of multiple primary cancer. Clinical features and outcome of multiple primary cancers involving HCC were reported only in few studies. Around 7% HCC had one or two associated extrahepatic malignancies. By using National Health Insurance Research Database of Taiwan to identify HCC patients with second primary cancer, 1.6% of HCC patients developed second primary cancer after 90 days of HCC diagnosis. However, the major limitation lies in the essence of National Health Insurance Research Database. There were no detailed clinical and laboratory data, imaging studies and pathology information. In this study, we will set up a database composed of double or multiple malignancy. One of these malignancy should be HCC. The eligible patients will be identified from cancer registry database of NTUH. Chart, pathological and image reviews will be done. The aim of this study is to investigate the clinical and pathological characteristics of HCC patients associated with multiple primary malignancies, The causes of second primary cancers or multiple primary cancers were complex and multifactorial, including common etiological factors with the primary cancer (such as tobacco, alcohol, and obesity), genetic predisposition, environmental factor, host factor, and combinations of these factors. To harness multiple primary cancer or second primary cancer, the prerequisite is to have clear clinical and pathological characteristics of these patients. Our results can provide clinicians for better managements of HCC patients and help scientists in the future study designs to harness the multiple primary cancers.
multiple primary cancer
second primary cancer