Hepatocellular carcinoma presenting with bone metastasis: Clinical characteristics and prognostic factors

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Abstract

Purpose: The survival of patients with hepatocellular carcinoma (HCC) has been prolonged with improvements in various diagnostic tools and treatment modalities. Consequently, bone metastases from HCC are diagnosed more frequently. We investigated the clinical features, prognosis, treatment outcomes, and prognostic factors of HCC presenting with bone metastasis. Methods: Between June 2000 and April 2007, we recruited 37 consecutive HCC patients presenting with bone metastasis. These patients were divided into an untreated control group (n = 16) and a treated group (n = 21). Results: The mean age of the patients was 61.1 years (male:female, 31:6). The most common cause of HCC was hepatitis B virus infection (56.8%). Twenty-two patients (59.5%) were of Child-Pugh class A and 15 (40.5%) were of Child-Pugh class B. Spinal metastasis was most common and noted in 21 patients (56.7%). The treatment modalities in the treated group included intra-arterial chemotherapy in nine patients (42.8%), systemic chemotherapy in five (23.8%), and both intra-arterial and systemic chemotherapy in seven (33.4%). The median survival of all patients was 6.2 months (range 0.7-46.6); that of untreated control group and the treated group was 2.9 (range 0.7-42.2) and 9.7 (range 0.9-46.6) months, respectively, with no significant difference (log-rank test, P = 0.081). Cox regression analysis revealed that the presence of ascites at the initial presentation was the only prognostic factor (P = 0.016). Conclusion: Although our study showed that locoregional and/or systemic chemotherapy did not provide significant survival prolongation compared to supportive care in patients with HCC initially accompanied by bone metastasis, a more large-scaled randomized study might be required.

Original languageEnglish
Pages (from-to)1377-1384
Number of pages8
JournalJournal of cancer research and clinical oncology
Volume134
Issue number12
DOIs
Publication statusPublished - 2008 Dec 1

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Hepatocellular Carcinoma
Neoplasm Metastasis
Bone and Bones
Drug Therapy
Survival
Control Groups
Virus Diseases
Ascites
Hepatitis B virus
Patient Care
Regression Analysis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

@article{a91fe0ae180f47428541b743aa64104c,
title = "Hepatocellular carcinoma presenting with bone metastasis: Clinical characteristics and prognostic factors",
abstract = "Purpose: The survival of patients with hepatocellular carcinoma (HCC) has been prolonged with improvements in various diagnostic tools and treatment modalities. Consequently, bone metastases from HCC are diagnosed more frequently. We investigated the clinical features, prognosis, treatment outcomes, and prognostic factors of HCC presenting with bone metastasis. Methods: Between June 2000 and April 2007, we recruited 37 consecutive HCC patients presenting with bone metastasis. These patients were divided into an untreated control group (n = 16) and a treated group (n = 21). Results: The mean age of the patients was 61.1 years (male:female, 31:6). The most common cause of HCC was hepatitis B virus infection (56.8{\%}). Twenty-two patients (59.5{\%}) were of Child-Pugh class A and 15 (40.5{\%}) were of Child-Pugh class B. Spinal metastasis was most common and noted in 21 patients (56.7{\%}). The treatment modalities in the treated group included intra-arterial chemotherapy in nine patients (42.8{\%}), systemic chemotherapy in five (23.8{\%}), and both intra-arterial and systemic chemotherapy in seven (33.4{\%}). The median survival of all patients was 6.2 months (range 0.7-46.6); that of untreated control group and the treated group was 2.9 (range 0.7-42.2) and 9.7 (range 0.9-46.6) months, respectively, with no significant difference (log-rank test, P = 0.081). Cox regression analysis revealed that the presence of ascites at the initial presentation was the only prognostic factor (P = 0.016). Conclusion: Although our study showed that locoregional and/or systemic chemotherapy did not provide significant survival prolongation compared to supportive care in patients with HCC initially accompanied by bone metastasis, a more large-scaled randomized study might be required.",
author = "Kim, {Seung Up} and Kim, {Do Young} and Park, {Jun Yong} and Ahn, {Sang Hoon} and Nah, {Hyung Joong} and Chon, {Chae Yoon} and Han, {Kwang Hyub}",
year = "2008",
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doi = "10.1007/s00432-008-0410-6",
language = "English",
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TY - JOUR

T1 - Hepatocellular carcinoma presenting with bone metastasis

T2 - Clinical characteristics and prognostic factors

AU - Kim, Seung Up

AU - Kim, Do Young

AU - Park, Jun Yong

AU - Ahn, Sang Hoon

AU - Nah, Hyung Joong

AU - Chon, Chae Yoon

AU - Han, Kwang Hyub

PY - 2008/12/1

Y1 - 2008/12/1

N2 - Purpose: The survival of patients with hepatocellular carcinoma (HCC) has been prolonged with improvements in various diagnostic tools and treatment modalities. Consequently, bone metastases from HCC are diagnosed more frequently. We investigated the clinical features, prognosis, treatment outcomes, and prognostic factors of HCC presenting with bone metastasis. Methods: Between June 2000 and April 2007, we recruited 37 consecutive HCC patients presenting with bone metastasis. These patients were divided into an untreated control group (n = 16) and a treated group (n = 21). Results: The mean age of the patients was 61.1 years (male:female, 31:6). The most common cause of HCC was hepatitis B virus infection (56.8%). Twenty-two patients (59.5%) were of Child-Pugh class A and 15 (40.5%) were of Child-Pugh class B. Spinal metastasis was most common and noted in 21 patients (56.7%). The treatment modalities in the treated group included intra-arterial chemotherapy in nine patients (42.8%), systemic chemotherapy in five (23.8%), and both intra-arterial and systemic chemotherapy in seven (33.4%). The median survival of all patients was 6.2 months (range 0.7-46.6); that of untreated control group and the treated group was 2.9 (range 0.7-42.2) and 9.7 (range 0.9-46.6) months, respectively, with no significant difference (log-rank test, P = 0.081). Cox regression analysis revealed that the presence of ascites at the initial presentation was the only prognostic factor (P = 0.016). Conclusion: Although our study showed that locoregional and/or systemic chemotherapy did not provide significant survival prolongation compared to supportive care in patients with HCC initially accompanied by bone metastasis, a more large-scaled randomized study might be required.

AB - Purpose: The survival of patients with hepatocellular carcinoma (HCC) has been prolonged with improvements in various diagnostic tools and treatment modalities. Consequently, bone metastases from HCC are diagnosed more frequently. We investigated the clinical features, prognosis, treatment outcomes, and prognostic factors of HCC presenting with bone metastasis. Methods: Between June 2000 and April 2007, we recruited 37 consecutive HCC patients presenting with bone metastasis. These patients were divided into an untreated control group (n = 16) and a treated group (n = 21). Results: The mean age of the patients was 61.1 years (male:female, 31:6). The most common cause of HCC was hepatitis B virus infection (56.8%). Twenty-two patients (59.5%) were of Child-Pugh class A and 15 (40.5%) were of Child-Pugh class B. Spinal metastasis was most common and noted in 21 patients (56.7%). The treatment modalities in the treated group included intra-arterial chemotherapy in nine patients (42.8%), systemic chemotherapy in five (23.8%), and both intra-arterial and systemic chemotherapy in seven (33.4%). The median survival of all patients was 6.2 months (range 0.7-46.6); that of untreated control group and the treated group was 2.9 (range 0.7-42.2) and 9.7 (range 0.9-46.6) months, respectively, with no significant difference (log-rank test, P = 0.081). Cox regression analysis revealed that the presence of ascites at the initial presentation was the only prognostic factor (P = 0.016). Conclusion: Although our study showed that locoregional and/or systemic chemotherapy did not provide significant survival prolongation compared to supportive care in patients with HCC initially accompanied by bone metastasis, a more large-scaled randomized study might be required.

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U2 - 10.1007/s00432-008-0410-6

DO - 10.1007/s00432-008-0410-6

M3 - Article

C2 - 18483745

AN - SCOPUS:54949157603

VL - 134

SP - 1377

EP - 1384

JO - Journal of Cancer Research and Clinical Oncology

JF - Journal of Cancer Research and Clinical Oncology

SN - 0171-5216

IS - 12

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