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Prognosis of hepatocellular carcinoma patients with extrahepatic metastasis and the controllability of intrahepatic lesions

Authors
 Jung Il Lee  ;  Ja Kyung Kim  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Jun Yong Park  ;  Seung Up Kim  ;  Beom Kyung Kim  ;  Kwang Hyub Han  ;  Kwan Sik Lee 
Citation
 CLINICAL & EXPERIMENTAL METASTASIS, Vol.31(4) : 475-482, 2014 
Journal Title
 CLINICAL & EXPERIMENTAL METASTASIS 
ISSN
 0262-0898 
Issue Date
2014
MeSH
Adult ; Antineoplastic Agents/therapeutic use ; Bone Neoplasms/mortality ; Bone Neoplasms/secondary* ; Bone Neoplasms/therapy ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/secondary* ; Carcinoma, Hepatocellular/therapy ; Combined Modality Therapy ; Disease Progression ; Female ; Hepatectomy ; Humans ; Liver Neoplasms/mortality ; Liver Neoplasms/pathology* ; Liver Neoplasms/therapy ; Lung Neoplasms/mortality ; Lung Neoplasms/secondary* ; Lung Neoplasms/therapy ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate
Keywords
Hepatocellular carcinoma ; Metastasis ; Survival ; Treatment
Abstract
Although advanced hepatocellular carcinoma (HCC) with extrahepatic metastasis is recommended to be treated by a systemic chemotherapeutic agent without local treatment targeting the liver, studies reported that causes of death in these patients were mostly from progression of intrahepatic lesions. Thus, this study investigated prognosis and factors predicting survival in these patients so as to evaluate the role of local treatments against intrahepatic lesions when the patients already had extrahepatic metastasis. This retrospective study evaluated medical records of 277 patients with HCC and extrahepatic metastasis. The median survival was 5.9 months, and 257 patients died during the follow up. Factors affecting survival of HCC patients with extrahepatic metastasis were poor response to treatment of hepatic lesions (HR 2.207; 95 % CI; p < 0.001), applying local treatment specifically targeting intrahepatic lesions (HR 0.591; 95 % CI 0.436–0.803; p = 0.001), intrahepatic tumor size larger than 3 cm (HR 2.065; 95 % CI 1.444–2.954; p < 0.001), and ECOG performance status 2 or higher (HR 1.543; 95 % CI 1.057–2.253; p = 0.025). The patients with either complete or partial response to the therapy had 1- and 2-year survival rate of 48.8 and 12.1 % whereas patient with either stable or progressive disease had 1-year survival rate of 11.4 %. These results suggest that even in the HCC patients with extrahepatic metastasis, effective local treatment may still be beneficial for the survival especially in patients with acceptable performance status.
Full Text
http://link.springer.com/article/10.1007%2Fs10585-014-9641-x
DOI
10.1007/s10585-014-9641-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Kim, Ja Kyung(김자경) ORCID logo https://orcid.org/0000-0001-5025-6846
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
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
Lee, Jung Il(이정일) ORCID logo https://orcid.org/0000-0002-0142-1398
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/98553
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