Brain metastasis of hepatocellular carcinoma- single center experience

Although the most common intracranial neoplasm in the adult population is metastatic tumors, brain metastasis from hepatocellular carcnoma (HCC) are very rare. The aim of this study is to analyze patients with advanced HCC, in order to determine the incidence of brain metastasis and evaluate the clinicopathologic properties.

The records of HCC patients treated in our university between 2011 and 2019 were reviewed retrospectively. Patient characteristics, symptoms, laboratory data, treatment modalities, and survival after both the diagnosis of HCC and detection of brain metastasis were recorded.

Of the 119 hepatocellular carcinoma patients, 34 had metastasis, 8 of which were to the brain. The median time elapsed between the diagnosis of HCC and brain metastasis was 14.6 months and the median overall survival after the detection of brain metastasis was 1.6 months. In 34 patients with metastasis, median survival was 26.2 months for those without brain metastasis, whereas it was 15.8 months for those with brain metastasis ( P = 0.460). The survival times after brain metastasis were 11.6 and 3.9 months for the two patients treated with regorafenib and sorafenib after the detection of brain metastasis, respectively.

In this study, it was found that patients who were clinically eligible to receive tyrosine kinase inhibitors survived longer after the detection of brain metastasis. Our study shows that multidisciplinary evaluation of these patients is vital for treatment guidance, and survival outcomes can be improved with the advancements in surgical and radiotherapy techniques even in patients with poor prognosis.