A Systematic Review of Metastatic Hepatocellular Carcinoma to the Spine

Goodwin, C. Rory; Yanamadala, Vijay; Ruiz‐Valls, Alejandro; Abu-Bonsrah, Nancy; Shankar, Ganesh M.; Sankey, Eric W.; Boone, Christine; Clarke, Michelle J.; Bilsky, Mark H.; Laufer, Ilya; Fisher, Charles G.; Shin, John H.; Sciubba, Daniel M.

doi:10.1016/j.wneu.2016.04.026

Cited by 24 publications

(41 citation statements)

References 47 publications

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“…The median survival interval from SM to death was 3 months, and a good performance status and response to RT were found to significantly affect survival. Goodwin et al 3. performed a meta-analysis of 26 studies that described operative techniques used to treat SM.…”

Section: Discussionmentioning

confidence: 99%

“…Radiotherapy (RT) can effectively provide palliation of painful SM in approximately 60% to 97% of patients, with up to 32% of patients experiencing a complete response in terms of pain relief 4,15,16. Although spinal involvement is thought to indicate a poor prognosis,5,16 patients with SM exhibit widely variable survival durations, and certain patients have favorable lifespans of up to 2 years 3,4,15. In our previous report, the follow-up times of patients ranged from 0.5 to 125 months, and 32 of 192 patients (16.7%) survived for longer than 1 year 4.…”

Section: Introductionmentioning

confidence: 99%

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Establishment of a Disease-Specific Graded Prognostic Assessment for Hepatocellular Carcinoma Patients with Spinal Metastasis

Rim

Choi²,

Choi

et al. 2017

Gut and Liver

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Background/AimsHepatocellular carcinoma (HCC) patients with spinal metastasis (SM) show heterogeneous lengths of survival. In this study, we develop and propose a graded prognostic assessment for HCC patients with SM (HCC-SM GPA).MethodsWe previously reported the outcomes of 192 HCC patients with SM who received radiotherapy from April 1992 to February 2012. Prognostic factors that significantly affected survival in that study were used to establish the HCC-SM GPA. Validation was performed using an independent cohort of 63 patients recruited from September 2011 to March 2016.ResultsWe developed the HCC-SM GPA using the following factors: Eastern Cooperative Oncology Group performance status (0–2, 0 point; 3–4, 1 point), controlled primary HCC (yes, 0 point; no, 2 points), and extrahepatic metastases other than bone (no, 0 point; yes, 1 point). Patients were stratified into low (GPA=0), intermediate (GPA=1 to 2), and high risk (GPA=3 to 4). When applied to the validation cohort, the HCC-SM GPA determined median survival durations of 13.6, 4.8, and 2.6 months and 1-year overall survival rates of 58.3%, 17.8%, and 7.3% for the low-, intermediate-, and high-risk patient groups, respectively (p<0.001).ConclusionsOur newly proposed HCC-SM GPA successfully predicted survival outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Establishment of a Disease-Specific Graded Prognostic Assessment for Hepatocellular Carcinoma Patients with Spinal Metastasis

Rim

Choi²,

Choi

et al. 2017

Gut and Liver

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“…HCC represents the most common primary tumour of the liver and the fifth most common cancer in the world. 1 We describe, to the best of our knowledge, the first case of HCC in a female patient without any evidence of underlying liver disease, who presented with unknown isolated HCC metastasis to the occipito-cervical junction C0-C1 and cervical instability due to tumour infiltration and destruction of the atlanto-occipital joint.…”

mentioning

confidence: 90%

“…A recent systematic review about metastatic HCC to the spine identified a prevalence of cervical localizations for metastasis in about 14.5% of patients, whereas thoracic and lumbar localization were, respectively, in 44.7 and 22.4%. 1 Among patients with the cervical spine metastases, the results showed that the most frequent symptoms at the time of the diagnosis were neck pain and neurologic symptoms in 70% of cases, followed by pathological fractures in 25%. 1 Metastatic involvement of the atlanto-occipital junction is rare 2 with only 16 cases previously reported ( Table 1).…”

mentioning

confidence: 97%

“…1 Among patients with the cervical spine metastases, the results showed that the most frequent symptoms at the time of the diagnosis were neck pain and neurologic symptoms in 70% of cases, followed by pathological fractures in 25%. 1 Metastatic involvement of the atlanto-occipital junction is rare 2 with only 16 cases previously reported ( Table 1). [3][4][5][6][7][8][9][10] Specifically, the most frequent primary tumour was lung cancer in six cases, following by thyroid cancer in three patients.…”

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confidence: 97%

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Metastatic hepatocellular carcinoma to the occipito‐cervical junction: a unique case and literature review

Marco

Vecchio

Stefano

et al. 2018

ANZ Journal of Surgery

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Metastatic hepatocellular carcinoma to the bone diagnosed by fine needle aspiration in a veteran population

Ramani

Green

2022

Diagnostic Cytopathology

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Background Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide and it may present initially with extrahepatic spread in 5%–15% cases. It most commonly metastasizes to lungs, lymph nodes and adrenal glands. Skeletal metastases from HCC are uncommon and carry a very poor prognosis. Methods We retrospectively reviewed all fine needle aspiration (FNA) specimens of metastatic HCC at our institution from January 1994 to March 2021 using the SNOMED search computer option. Relevant clinical information was obtained from the review of patient's electronic medical records. Results There were 36 FNAs of metastatic HCC over a period of 27 years. Six patients (16.7%) were found to have skeletal metastases. All six patients were males with a median age of 59 years (54–71 years) and their lesions were osteolytic. The most common site of metastases was vertebra (3/50%). Most patients (67%) had bone metastases as an initial presentation, without prior history of HCC. The mean survival after the diagnosis of skeletal metastases was only 8 months. Conclusion Detection of extrahepatic HCC to bone is important to avoid any unwanted surgical intervention. In our patient population, the most common site of skeletal metastases from HCC was vertebra, therefore in FNAs of vertebral lytic masses, metastatic HCC should be considered. On FNA, extrahepatic metastases of HCC can mimic other poorly differentiated tumors. They behave in an aggressive fashion, resulting in a grim prognosis. Cytological substrates can be used for future molecular testing, if needed.

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A Systematic Review of Metastatic Hepatocellular Carcinoma to the Spine

Cited by 24 publications

References 47 publications

Establishment of a Disease-Specific Graded Prognostic Assessment for Hepatocellular Carcinoma Patients with Spinal Metastasis

Establishment of a Disease-Specific Graded Prognostic Assessment for Hepatocellular Carcinoma Patients with Spinal Metastasis

Metastatic hepatocellular carcinoma to the occipito‐cervical junction: a unique case and literature review

Metastatic hepatocellular carcinoma to the bone diagnosed by fine needle aspiration in a veteran population

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