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Advanced Hepatocellular Carcinoma with Bone Metastases: Prevalence, Associated Factors, and Survival Estimation

Xu Guo1,2, Yao Xu1, Xin Wang3

  • 1Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China (mainland).

Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
|February 11, 2019
PubMed

Insights

Bone metastases (BM) affect 4.29% of newly diagnosed liver cancer (HCC) patients. Male sex, advanced stage, and other metastases are risk factors, with median survival at 3 months.

Area of Science:

  • Oncology
  • Hepatology
  • Cancer Metastasis

Background:

  • Hepatocellular carcinoma (HCC) is a primary liver cancer with significant global health implications.
  • Bone metastases (BM) represent an advanced stage of cancer, impacting patient prognosis and quality of life.
  • Understanding the prevalence and risk factors for BM in HCC is crucial for early detection and improved management.

Purpose of the Study:

  • To investigate the prevalence of bone metastases at initial diagnosis in patients with hepatocellular carcinoma.
  • To identify risk factors associated with the development of bone metastases in newly diagnosed HCC.
  • To determine the prognostic factors influencing survival in HCC patients with bone metastases.

Main Methods:

  • Utilized the Surveillance, Epidemiology, and End Results (SEER) database, including 36,507 HCC patients diagnosed between 2010 and 2014.
  • Enrolled 1,263 patients diagnosed with bone metastases at initial HCC diagnosis.
  • Employed Kaplan-Meier curves, log-rank tests, and univariate/multivariate logistic and Cox regression analyses for survival and risk factor assessment.

Main Results:

  • A total of 1,567 (4.29%) HCC patients presented with bone metastases at initial diagnosis.
  • Positive associations with BM included male sex, unmarried status, higher T stage, lymph node involvement, intrahepatic, and extrahepatic metastases (lung or brain).
  • The median survival for patients with BM was 3.00 months; marital status and primary tumor surgery were linked to better survival.

Conclusions:

  • Identified key factors associated with the occurrence of bone metastases in hepatocellular carcinoma.
  • Determined prognostic factors for advanced HCC patients with bone metastases, highlighting the importance of marital status and surgery.
  • These findings can inform bone metastasis screening strategies and guide prophylactic treatment decisions in clinical practice.

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