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Incidence, Risk Factors, and Prognosis of Patients with Hepatocellular Carcinoma and Brain Metastases

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Abstract

Objective

Brain metastases significantly impact the clinical course of patients with hepatocellular carcinoma (HCC). This study aimed to examine the age-related incidence, demographics, and survival of patients with HCC and brain metastases.

Methods

Data of HCC patients from 2010 to 2015 in the Surveillance, Epidemiology, and End Results (SEER) Registry were screened for the presence of brain metastases. They were stratified by age and ethnicity. Multivariable logistic and Cox regression analyses were used to identify factors associated with brain metastases and those with overall survival (OS) and liver cancer-specific survival (CSS), respectively.

Results

A total of 141 HCC patients presenting with brain metastases were identified, accounting for 0.35% of all HCC patients and 2.37% of patients with metastatic disease. Among all HCC patients, the incidence rate was the highest among patients aged 30–49 years old (0.47%). Ethnicity was not associated with the presence of brain metastases at the time of HCC diagnosis. However, African-American patients presented with a significantly lower disease-specific survival [median time: 1 month; interquartile range (IQR): 0–3.0 months)]. Initial lung or bone metastasis was independently associated with an increased risk of the presence of brain metastases [odds ratio (OR): 12.62, 95% confidence interval (CI): 8.40–18.97] but was not associated with a worse OS or CSS among those with brain metastases.

Conclusion

This study identified the age-related incidence and risk factors of brain metastases in HCC patients. These results may contribute to the consideration of brain screening among patients with initial metastatic HCC with lung or bone metastases, and influence the counseling of this patient population regarding their prognosis.

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Author notes

  1. These authors contributed equally to this study.

Authors and Affiliations

  1. Department of Liver Transplantation, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Jin-cheng Feng, Jian Xin & Jun Xiong

  2. Key Laboratory of Transplant Engineering and Immunology, Laboratory of Liver Transplantation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China

    Ying He

  3. Department of General, Visceral and Transplant Surgery, University of Heidelberg, Im Neuenheimer Feld 110, Heidelberg, 69120, Germany

    Georgios Polychronidis

  4. Department of Hepatobiliary and Pancreatic Surgery, Fujian Provincial Hospital, Fuzhou, 350001, China

    Shen You

Authors
  1. Jin-cheng Feng
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  2. Ying He
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  3. Georgios Polychronidis
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  4. Jian Xin
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  5. Shen You
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  6. Jun Xiong
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Correspondence to Shen You or Jun Xiong.

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Feng, Jc., He, Y., Polychronidis, G. et al. Incidence, Risk Factors, and Prognosis of Patients with Hepatocellular Carcinoma and Brain Metastases. CURR MED SCI 44, 180–186 (2024). https://doi.org/10.1007/s11596-023-2809-3

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  • DOI: https://doi.org/10.1007/s11596-023-2809-3

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