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Hepatocellular carcinoma presenting with bone metastasis: clinical characteristics and prognostic factors.

Authors
 Seung Up Kim  ;  Do Young Kim  ;  Jun Yong Park  ;  Sang Hoon Ahn  ;  Hyung Joong Nah  ;  Chae Yoon Chon  ;  Kwang-Hyub Han 
Citation
 JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, Vol.134(12) : 1377-1384, 2008 
Journal Title
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
ISSN
 0171-5216 
Issue Date
2008
MeSH
Bone Neoplasms/drug therapy ; Bone Neoplasms/secondary* ; Carcinoma, Hepatocellular/drug therapy ; Carcinoma, Hepatocellular/secondary* ; Female ; Humans ; Liver Neoplasms/drug therapy ; Liver Neoplasms/pathology* ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate
Keywords
Bone metastasis ; Hepatocellular carcinoma ; Prognosis ; Survival ; Treatment outcome ; 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.
Full Text
http://link.springer.com/article/10.1007%2Fs00432-008-0410-6
DOI
10.1007/s00432-008-0410-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108203
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