[Gender-specific influencing factors on incidence, risk factors and outcome of carcinoma of the liver, gallbladder, extrahepatic bile duct and pancreas]

The epidemiology of hepatocellular cancer in Poland

Introduction

This article summarize the available data on hepatocellular carcinoma (HCC) epidemiology in Poland. Data regarding the HCC incidence rate are divergent. Statistical data presented by NFZ appear more credible in that matter than data published by the Polish Oncology Center (POC).

Material and methods

The analysis included data from the Polish Bibliography Database (GBL), the Polish National Health Fund Institution (NFZ), the scientific paper “Malignant neoplasms in Poland” issued by POC and the central liver transplant registry maintained by the Polish transplant coordinating center “Poltransplant” (2010-2015).

Results

Data regarding the HCC incidence rate are divergent. Statistical data presented by NFZ appear more credible in that matter than data published by POC.

Conclusions

The occurrence of HCC in Poland is at the average European level and is similarly rising. The incidence rate is underestimated. It is due to faulty epidemiology data collection techniques. The highest risk group comprises men over the age of 50 with concomitant liver cirrhosis. The most common HCC etiology is HCV infection.

Projections of cancer incidence and cancer-related deaths in Germany by 2020 and 2030

Past patterns of cancer disease and future changes in the demographic structure have a major influence on the projected incidences of human malignancies. In Germany, nearly a quarter of men and 20% of women die of cancer, and it is estimated that in Germany around 51% men and 43% women will develop cancer during lifetime. Here, we project the cancer incidence case number as well as the number of deaths for the most common cancers in the German population for the years 2020 and 2030. By 2030, prostate cancer will be the most common malignancy, surpassing breast cancer. Lung cancer will rank third most frequent cancer and will remain the most common cause of cancer‐related mortality. Additionally, our projections show a marked increase in liver cancer cases with a continuous rise in liver cancer‐related deaths. Finally, we project a constant increase in the incidence of pancreatic cancer. Based on our projections, pancreatic cancer will surpass colorectal and breast cancer to rank as the second most common cause of cancer‐related deaths in Germany by 2030.

Clinical and prognostic significance of preoperative plasma hyperfibrinogenemia in gallbladder cancer patients following surgical resection: a retrospective and in vitro study

Background

Coagulation and fibrinolysis activation is frequently observed in cancer patients, and the tumors in these cases are thought to be associated with a higher risk of invasion, metastasis, and worse long-term outcome. The objective of this study was to elucidate the prognostic significance of blood coagulation tests and various clinicopathological characteristics in patients with gallbladder cancer (GBC) after surgical resection.

Methods

We retrospectively reviewed the medical records of 115 patients with histologically confirmed GBC who underwent surgical resection in our department. The prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), international normalized ratio (INR), fibrinogen levels, and platelet counts were measured pretreatment at the time of diagnosis. The predictive value of fibrinogen levels for tumor staging was evaluated using a receiver operating characteristic (ROC) curve analysis. Correlations between the preoperative hyperfibrinogenemia and clinicopathological characteristics were analyzed, and univariate and multivariate survival analyses were performed to identify the factors associated with overall survival (OS). Cancer cell migration and invasion in vitro were examined to investigate the function of fibrinogen in GBC cell migration.

Results

The plasma levels for all coagulation tests, with the exception of INR, were significantly different between the GBC patients and control patients (p < 0.001). Hyperfibrinogenemia (>402 mg/dL) was associated with poorly differentiated tumors, advanced tumor invasion, lymphatic metastasis, and advanced tumor stage (p < 0.001), and had a statistically significant adverse effect on survival (p = 0.001). In the multivariate analysis, hyperfibrinogenemia (p = 0.031) was independently associated with worse OS, tumor stage (p = 0.016), margin status (p < 0.001), and lymphatic metastasis (p = 0.035). Moreover, cell migration and invasion in vitro were significantly enhanced by fibrinogen.

Conclusions

Preoperative plasma fibrinogen levels was associated with tumor progression and may be an independent marker of poor prognosis in GBC patients. Furthermore, fibrinogen may contribute to cell migration by inducing epithelial-mesenchymal transition.