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Erschienen in: Journal of Gastrointestinal Cancer 4/2017

11.09.2017 | Review Article

Hepatocellular Carcinoma with Bone Metastases: Incidence, Prognostic Significance, and Management—Single-Center Experience

verfasst von: Ruchi Bhatia, Sravanthi Ravulapati, Alex Befeler, John Dombrowski, Sameer Gadani, Nishant Poddar

Erschienen in: Journal of Gastrointestinal Cancer | Ausgabe 4/2017

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Abstract

Background

Hepatocellular carcinoma (HCC) represents one of the most common causes of cancer-related deaths worldwide, with rising incidence in the USA. Bone metastases with HCC, in particular, have an extremely poor prognosis. We present prevalence, treatment, and survival of patients with bone and more specifically spinal metastases from HCC.

Methods

A retrospective analysis was done at a single tertiary care institution of patients with bone metastases from HCC between January 2005 and December 2015.

Results

Among 1017 patients with HCC, 20 were found to have bone metastases of which 11 had spinal metastases. Seventeen (85%) were male, with median age of 58 years at time of HCC diagnosis. Systemic chemotherapy and sorafenib were used in 12 (60%) patients, and 12 (60%) received radiation therapy. Among patients who did not receive therapy, median survival was 76 days. Median survival after diagnosis of metastasis in patients on sorafenib and radiation were 106 and 100 days, respectively.

Conclusion

Bone metastases in HCC are very rare and aggressive. Due to its rarity, optimal treatment strategies are not well defined. Early diagnosis is important for optimal therapy and improved survival.
Literatur
1.
Zurück zum Zitat Suresh VS, Babu KG, Lokanatha D, Bapsy PP, Ramachandra C, Rajshekar H. Bone metastasis in hepatocellular carcinoma: need for reappraisal of treatment. J Cancer Res Therapy June. 2008;4:2. Suresh VS, Babu KG, Lokanatha D, Bapsy PP, Ramachandra C, Rajshekar H. Bone metastasis in hepatocellular carcinoma: need for reappraisal of treatment. J Cancer Res Therapy June. 2008;4:2.
2.
Zurück zum Zitat Clark HP, Carson WF, Kavanagh PV, et al. Staging and current treatment of hepatocellular carcinoma. Radiographics. 2005;25:S3–23.CrossRefPubMed Clark HP, Carson WF, Kavanagh PV, et al. Staging and current treatment of hepatocellular carcinoma. Radiographics. 2005;25:S3–23.CrossRefPubMed
3.
Zurück zum Zitat Lin S, Hoffman K, Schemer P. Treatment of hepatocellular carcinoma: a systemic review. Liver Cancer. 2012:144–58. Lin S, Hoffman K, Schemer P. Treatment of hepatocellular carcinoma: a systemic review. Liver Cancer. 2012:144–58.
4.
Zurück zum Zitat Okazaki N, Yoshino M, Yoshida T, Hirohashi S, Kishi K, Shimosato Y. Bone metastases in hepatocellular carcinoma. Cancer. 1985;55:1991–4.CrossRefPubMed Okazaki N, Yoshino M, Yoshida T, Hirohashi S, Kishi K, Shimosato Y. Bone metastases in hepatocellular carcinoma. Cancer. 1985;55:1991–4.CrossRefPubMed
5.
Zurück zum Zitat Brown RS, Kumar KS, Russo MW, et al. Model for end-stage liver disease and Child-Turcotte-Pugh score as predictors of pretransplantation disease severity, posttransplantation outcome, and resource utilization in united network for organ sharing status 2A patients. Liver Transpl. 2002;8(3):278–84.CrossRefPubMed Brown RS, Kumar KS, Russo MW, et al. Model for end-stage liver disease and Child-Turcotte-Pugh score as predictors of pretransplantation disease severity, posttransplantation outcome, and resource utilization in united network for organ sharing status 2A patients. Liver Transpl. 2002;8(3):278–84.CrossRefPubMed
6.
Zurück zum Zitat Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334:693–9.CrossRefPubMed Mazzaferro V, Regalia E, Doci R, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med. 1996;334:693–9.CrossRefPubMed
7.
Zurück zum Zitat He J, Zeng ZC, Tang ZY, et al. Clinical features and prognostic factors in patients with bone metastases from hepatocellular carcinoma receiving external beam radiotherapy. Cancer. 2009;115:2710–20.CrossRefPubMed He J, Zeng ZC, Tang ZY, et al. Clinical features and prognostic factors in patients with bone metastases from hepatocellular carcinoma receiving external beam radiotherapy. Cancer. 2009;115:2710–20.CrossRefPubMed
8.
Zurück zum Zitat Fukutomi M, Yokota M, Chuman H, Harada H, Zaitsu Y, Funakoshi A, et al. Increased incidence of bony metastases in hepatocellular carcinoma. Eur J Gastroenterol Hepatol. 2001;13:1083–8.CrossRefPubMed Fukutomi M, Yokota M, Chuman H, Harada H, Zaitsu Y, Funakoshi A, et al. Increased incidence of bony metastases in hepatocellular carcinoma. Eur J Gastroenterol Hepatol. 2001;13:1083–8.CrossRefPubMed
9.
Zurück zum Zitat Tamaki K, Shimizu I, Urata M, et al. A patient with spinal metastasis from hepatocellular carcinoma discovered from neurological findings. World J Gastroenterol. 2007;13(19):2758–60.CrossRefPubMedPubMedCentral Tamaki K, Shimizu I, Urata M, et al. A patient with spinal metastasis from hepatocellular carcinoma discovered from neurological findings. World J Gastroenterol. 2007;13(19):2758–60.CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Zhu A. Systemic therapy of advanced hepatocellular carcinoma: how hopeful should we be? The Oncologist July. 2006;11(7):790–800.CrossRef Zhu A. Systemic therapy of advanced hepatocellular carcinoma: how hopeful should we be? The Oncologist July. 2006;11(7):790–800.CrossRef
11.
Zurück zum Zitat Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359(4):378–90.CrossRefPubMed Llovet JM, Ricci S, Mazzaferro V, Hilgard P, Gane E, Blanc JF, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359(4):378–90.CrossRefPubMed
12.
Zurück zum Zitat Cheng AL, KangYK CZ, Tsao CJ, Qin S, Kim JS, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol. 2009;10(1):25–34.CrossRefPubMed Cheng AL, KangYK CZ, Tsao CJ, Qin S, Kim JS, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol. 2009;10(1):25–34.CrossRefPubMed
13.
Zurück zum Zitat National Comprehensive Cancer Network guidelines. Version 1.2016. Hepatocellular carcinoma (Accessed February 2016). National Comprehensive Cancer Network guidelines. Version 1.2016. Hepatocellular carcinoma (Accessed February 2016).
14.
Zurück zum Zitat Kaizu YT, Karasawa K, Tanaka Y, Matuda T, Kurosaki H, Tanaka S, et al. Radiotherapy for osseous metastasis from hepatocellular carcinoma: a retrospective study of 57 patients. Am J Gastroenterol. 1998;93:2167–71.CrossRefPubMed Kaizu YT, Karasawa K, Tanaka Y, Matuda T, Kurosaki H, Tanaka S, et al. Radiotherapy for osseous metastasis from hepatocellular carcinoma: a retrospective study of 57 patients. Am J Gastroenterol. 1998;93:2167–71.CrossRefPubMed
15.
Zurück zum Zitat Seong J, Koom WS, Park HC. Radiotherapy for painful bone metastasis from hepatocellular carcinoma. Liver Int. 2005;25:261–5.CrossRefPubMed Seong J, Koom WS, Park HC. Radiotherapy for painful bone metastasis from hepatocellular carcinoma. Liver Int. 2005;25:261–5.CrossRefPubMed
16.
Zurück zum Zitat Choi C, Seong J. Predictive factors of palliative radiotherapy response and survival in patients with spinal metastases from hepatocellular carcinoma. Gut and Liver. 2015;9:94–102.CrossRefPubMed Choi C, Seong J. Predictive factors of palliative radiotherapy response and survival in patients with spinal metastases from hepatocellular carcinoma. Gut and Liver. 2015;9:94–102.CrossRefPubMed
Metadaten
Titel
Hepatocellular Carcinoma with Bone Metastases: Incidence, Prognostic Significance, and Management—Single-Center Experience
verfasst von
Ruchi Bhatia
Sravanthi Ravulapati
Alex Befeler
John Dombrowski
Sameer Gadani
Nishant Poddar
Publikationsdatum
11.09.2017
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Cancer / Ausgabe 4/2017
Print ISSN: 1941-6628
Elektronische ISSN: 1941-6636
DOI
https://doi.org/10.1007/s12029-017-9998-6

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