Zhang YL, Liu ZR, Liu Z, Bai Y, Chi H, Chen DP, Zhang YM, Cui ZL. Risk of cardiovascular death in patients with hepatocellular carcinoma based on the Fine-Gray model. World J Gastrointest Oncol 2024; 16(3): 844-856 [PMID: 38577452 DOI: 10.4251/wjgo.v16.i3.844]
Corresponding Author of This Article
Zi-Lin Cui, PhD, Surgeon, Department of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China. 13602184643@163.com
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Mar 15, 2024; 16(3): 844-856 Published online Mar 15, 2024. doi: 10.4251/wjgo.v16.i3.844
Risk of cardiovascular death in patients with hepatocellular carcinoma based on the Fine-Gray model
Yu-Liang Zhang, Zi-Rong Liu, Zhi Liu, Yi Bai, Hao Chi, Da-Peng Chen, Ya-Min Zhang, Zi-Lin Cui
Yu-Liang Zhang, Hao Chi, Da-Peng Chen, First Central Clinical College, Tianjin Medical University, Tianjin 300070, China
Zi-Rong Liu, Zhi Liu, Yi Bai, Ya-Min Zhang, Zi-Lin Cui, Department of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin 300192, China
Author contributions: Cui ZL had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis; Cui ZL and Zhang YL designed the research study; Zhang YL and Cui ZL performed the primary literature and data extraction; Zhang YL, Liu ZR, Liu Z, Bai Y, Chi H and Chen DP analyzed the data; Zhang YL and Cui ZL wrote the manuscript; Cui ZL, Bai Y and Zhang YM critically revised the manuscript for important intellectual content; and all authors read and approved the final version.
Supported byHealth Technology Project of Tianjin, No. ZC20175.
Institutional review board statement: The data for this study came from a public database (SEER database), so this statement does not applicable.
Informed consent statement: The data for this study came from a public database (SEER database), so this statement does not applicable.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: The data are available on application to the SEER database (https://seer.cancer.gov/). Technical appendix and statistical code from the corresponding author at 13602184643@163.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zi-Lin Cui, PhD, Surgeon, Department of Hepatobiliary Surgery, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fukang Road, Nankai District, Tianjin 300192, China. 13602184643@163.com
Received: October 20, 2023 Peer-review started: October 20, 2023 First decision: December 5, 2023 Revised: December 15, 2023 Accepted: January 17, 2024 Article in press: January 17, 2024 Published online: March 15, 2024 Processing time: 144 Days and 3.6 Hours
ARTICLE HIGHLIGHTS
Research background
Hepatocellular carcinoma (HCC) is one of the most common tumors today. It is known that patients with HCC will have a higher risk of cardiovascular disease (CVD) death compared to non-HCC patients.
Research motivation
CVD is recognized as one of the most common complications of cancer treatment. As medical technology continues to mature, studies have found that the 5-year survival rate for HCC patients can be increased to 70% with early diagnosis and some potential treatments. Just because there are some unique treatment modalities (e.g. Transcatheter arterial chemoembolization) for HCC patients that have some limitations on the potential cardiotoxicity of drugs, it does not mean that we can ignore the potential cardiovascular burden of HCC patients.
Research objectives
The aim of this study was to identify the independent risk factors for CVD death in HCC patients, and to further provide a reference tool for the relevant clinical management decisions of HCC patients by constructing a prediction model for CVD death in HCC patients.
Research methods
In this study, data related to adult HCC patients with diagnosis years 2010-2015 in the Surveillance, Epidemiology, and End Results database were collected. In order to better eliminate the influence of competing events on the study, we utilized the Fine-Gray model to carry out the analysis and constructed a predictive model.
Research results
The study included 21545 patients with HCC, of whom 619 died of CVD. Age, marital status, alpha fetoprotein, tumor size, surgery, and chemotherapy were independent risk factors for CVD death in HCC patients. The discrimination as well as the calibration of the nomograph was better. Decision curve analysis demonstrated that the prediction model has a high net benefit.
Research conclusions
This study focuses on the cardiovascular risk of HCC patients for the first time. Meanwhile, the independent risk factors for CVD deaths in HCC patients were explored for the first time based on the Fine-Gray model, and a prediction model was constructed, which will serve as a reminder for future clinical work.
Research perspectives
Focusing on the burden of CVD in HCC patients and further exploring the impact of different drugs and routes of administration on CVD death in HCC patients.
