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Updated: Aug 15, 2026
A Three-Dimensional Spheroid Model to Investigate the Tumor-Stromal Interaction in Hepatocellular Carcinoma
Published on: September 30, 2021
Clinical features of hepatocellular carcinoma with extrahepatic metastases
Mitsuteru Natsuizaka1, Takumi Omura, Toru Akaike
1Gastroenterology and Hematology Section, Department of Internal Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan. natsu-m@med.hokudai.ac.jp
Insights
Extrahepatic metastases of hepatocellular carcinoma (HCC) are common in advanced intrahepatic tumors. Early detection and consideration of metastatic sites like the lung and bone are crucial for patient prognosis.
Area of Science:
- Hepatobiliary Malignancies
- Oncology
- Clinical Medicine
Background:
- Detailed clinical reports on extrahepatic metastases of hepatocellular carcinoma (HCC) are scarce.
- Understanding the clinical features of HCC spread is essential for effective patient management.
Purpose of the Study:
- To elucidate the clinical features of extrahepatic metastases in patients with hepatocellular carcinoma (HCC).
- To identify risk factors and common sites of HCC metastasis.
Main Methods:
- Retrospective review of clinical records of 482 HCC patients diagnosed between January 1995 and March 2001.
- Analysis of clinical features in 65 patients with confirmed extrahepatic metastases.
Main Results:
- Patients with extrahepatic metastases often presented with advanced intrahepatic tumors (T3/T4) and vessel invasion.
- Common metastatic sites included the lung (53.8%), bone (38.5%), and lymph nodes (33.8%).
- Median survival was 7 months, with a 1-year survival rate of 24.9%; advanced Child-Pugh grade and elevated alpha-fetoprotein correlated with poor prognosis.
Conclusions:
- Extrahepatic metastases of HCC are not rare and should be considered in HCC patient evaluation.
- Identifying patients with advanced intrahepatic tumors is key for predicting metastasis.
- Awareness of metastatic patterns aids in precise staging and treatment planning for HCC.
Background:
There are few detailed clinical reports about extrahepatic metastases of hepatocellular carcinoma (HCC). The purpose of the present study was to elucidate the clinical features of extrahepatic metastases of HCC.
Methods:
The clinical records of 482 patients who had been diagnosed as having HCC during the period from January 1995 to March 2001 were retrospectively reviewed. Extrahepatic metastases had been detected in 65 patients. Clinical features of those 65 patients were analyzed.
Results:
Patients with extrahepatic metastases had more advanced intrahepatic tumors at the first diagnosis of HCC: 73.8% of the patients with extrahepatic metastases had tumors of intrahepatic tumor stage T3 or T4 according to the TNM classification, while only 28.5% of the patients without extrahepatic metastases had tumors of T3 or T4 (P < 0.001). Vessel invasion was also detected at the first diagnosis of HCC more frequently in the patients with extrahepatic metastasis (P < 0.001). The frequent metastatic sites were lung (53.8%), bone (38.5%), and lymph node (33.8%). Other metastatic sites were the adrenal gland, peritoneum, skin, brain and muscle. The median survival time and 1-year survival rate were 7 months (range: 1-59 months) and 24.9%, respectively. Patients with Child-Pugh grade B and C (P = 0.0018) and patients with positive serum alpha-fetoprotein (P = 0.011) had significantly poor prognosis.
Conclusions:
Extrahepatic metastases of HCC are not rare. The possibility of extrahepatic metastases and the clinical features of extrahepatic metastases should be considered when examining patients with HCC, particularly those with advanced intrahepatic tumors, to enable precise evaluation of the spread of HCC and determination of the appropriate treatment method.
