Pyogenic Liver Abscess

Cancer risk in patients with pyogenic liver abscess: a nationwide cohort study

  1. W.-Y. Kao1,2,3,†,
  2. C.-Y. Hwang4,5,†,
  3. Y.-T. Chang4,5,
  4. C.-W. Su1,2,6,*,
  5. M.-C. Hou1,2,
  6. H.-C. Lin1,2,
  7. F.-Y. Lee1,2,
  8. S.-D. Lee7,
  9. J.-C. Wu6,8

Article first published online: 10 JUL 2012

DOI: 10.1111/j.1365-2036.2012.05212.x

Issue

Alimentary Pharmacology & Therapeutics

Alimentary Pharmacology & Therapeutics

Volume 36, Issue 5, pages 467–476, September 2012

Additional Information

How to Cite

Kao, W.-Y., Hwang, C.-Y., Chang, Y.-T., Su, C.-W., Hou, M.-C., Lin, H.-C., Lee, F.-Y., Lee, S.-D. and Wu, J.-C. (2012), Cancer risk in patients with pyogenic liver abscess: a nationwide cohort study. Alimentary Pharmacology & Therapeutics, 36: 467–476. doi: 10.1111/j.1365-2036.2012.05212.x

Author Information

  1. 1

    Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

  2. 2

    Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

  3. 3

    Division of Gastroenterology, Department of Medicine, Taoyuan branch, Taipei Veterans General Hospital, Taipei, Taiwan

  4. 4

    Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan

  5. 5

    Department of Dermatology, National Yang-Ming University, Taipei, Taiwan

  6. 6

    Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan

  7. 7

    Cheng Hsin General Hospital, Taipei, Taiwan

  8. 8

    Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan

  1. †

    Drs WY Kao and CY Hwang contributed equally to this work.

* Correspondence to:
Dr C.-W. Su, Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, 201 Shih-Pai Road, Sec. 2, Taipei 112, Taiwan.
E-mail: cwsu2@vghtpe.gov.tw

  1. †

    Drs WY Kao and CY Hwang contributed equally to this work.

Publication History

  1. Issue published online: 5 AUG 2012
  2. Article first published online: 10 JUL 2012
  3. Manuscript Accepted: 20 JUN 2012
  4. Manuscript Revised: 14 JUN 2012
  5. Manuscript Revised: 4 APR 2012
  6. Manuscript Received: 25 FEB 2012

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Summary

Background

There has been no large-scale population-based study on the relationship between pyogenic liver abscesses (PLA) and subsequent cancer risk.

Aim

To estimate all cancer risk following a diagnosis of PLA.

Methods

Based on Taiwan's National Health Insurance Research Database, 1257 patients with PLA without prior cancers in the period 1996–2008 were identified and followed-up. The standard incidence ratio (SIR) of each cancer was calculated as the number of observed cancer cases arising among the PLA patients divided by the expected case number of cancer cases according to the national cancer rates.

Results

Of the 1257 PLA patients identified, 598 (47.6%) had diabetes mellitus. After a median (±s.d.) follow-up of 3.33 ± 3.45 years, 186 were diagnosed with cancers, including 56 liver cancer, 22 biliary tract cancer and 40 colorectal cancer patients. Patients with PLA had a higher risk of all cancers (SIR, 3.83; 95% CI, 3.30–4.42), liver cancer (SIR, 7.87; 95% CI, 5.94–10.21), biliary tract cancer (SIR, 34.58; 95% CI, 21.67–52.36) and colorectal cancer (SIR, 5.27; 95% CI, 3.76–7.18). The highest SIRs of all cancers, liver cancer, biliary tract cancer and colorectal cancer occurred within 90 days of follow-up (360.82; 95% CI, 278.46–459.91, 257.28; 95% CI, 186.17–346.56, 1153.38; 95% CI 694.08–1801.24, and 52.63; 95% CI 25.2–96.8 respectively).

Conclusions

Pyogenic liver abscesses may herald the onset of cancer, especially hepato-biliary and colon cancer. Further surveys should be conducted for the detection of occult cancers in such patients.

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