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Bone metastasis of hepatocellular carcinoma: facts and hopes from clinical and translational perspectives

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Abstract

Patients with hepatocellular carcinoma (HCC) and bone metastasis (BM) suffer from greatly reduced life quality and a dismal prognosis. However, BM in HCC has long been overlooked possibly due to its relatively low prevalence in previous decades. To date, no consensus or guidelines have been reached or formulated for the prevention and management of HCC BM. Our narrative review manifests the increasing incidence of HCC BM to sound the alarm for additional attention. The risk factors, diagnosis, prognosis, and therapeutic approaches of HCC BM are detailed to provide a panoramic view of this disease to clinicians and specialists. We further delineate an informative cancer bone metastatic cascade based on evidence from recent studies and point out the main factors responsible for the tumor-associated disruption of bone homeostasis and the formation of skeletal cancer lesions. We also present the advances in the pathological and molecular mechanisms of HCC BM to shed light on translational opportunities. Dilemmas and challenges in the treatment and investigation of HCC BM are outlined and discussed to encourage further endeavors in the exploration of underlying pathogenic and molecular mechanisms, as well as the development of novel effective therapies for HCC patients with BM.

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Acknowledgements

This study was supported by the National Natural Science Foundation of China (Nos. 81372327, 81572427, and 81874189); the State Key Project on Infection Disease of China (No. 2018ZX10723204-003-003); the National Key Research and Development Program of China (No. 2018YFA0208904); the Major Technological Innovation Projects of Hubei Province (No. 2018ACA137); the Fundamental Research Funds for the Central Universities, HUST (No. 5001540059).

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Authors and Affiliations

  1. Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Zhao Huang, Jingyuan Wen, Yufei Wang, Shenqi Han, Junnan Liang, Huifang Liang, Xiao-ping Chen & Bixiang Zhang

  2. Clinical Medical Research Center of Hepatic Surgery at Hubei Province, Wuhan, 430030, China

    Zhao Huang, Jingyuan Wen, Yufei Wang, Shenqi Han, Junnan Liang, Huifang Liang, Xiao-ping Chen & Bixiang Zhang

  3. Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Zhao Huang, Jingyuan Wen, Yufei Wang, Shenqi Han, Junnan Liang, Huifang Liang, Xiao-ping Chen & Bixiang Zhang

  4. Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Zhen Li & Xuemei Hu

  5. Department of Nuclear Medicine and PET, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China

    Dongling Zhu

  6. Department of Radiology, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, 510180, China

    Zhenxiong Wang

  7. Key Laboratory of Organ Transplantation, Ministry of Education; Key Laboratory of Organ Transplantation, National Health Commission; Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Wuhan, 430030, China

    Xiao-ping Chen & Bixiang Zhang

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  1. Zhao Huang
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Zhao Huang, Jingyuan Wen, Yufei Wang, Shenqi Han, Zhen Li, Xuemei Hu, Dongling Zhu, Zhenxiong Wang, Junnan Liang, Huifang Liang, Xiao-ping Chen, and Bixiang Zhang declare that they have no conflict of interest. This manuscript is a review article and does not involve a research protocol requiring approval by the relevant institutional review board or ethics committee.

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Huang, Z., Wen, J., Wang, Y. et al. Bone metastasis of hepatocellular carcinoma: facts and hopes from clinical and translational perspectives. Front. Med. 16, 551–573 (2022). https://doi.org/10.1007/s11684-022-0928-z

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