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International Journal of Clinical Oncology

, Volume 24, Issue 6, pp 666–676 | Cite as

Control of intracranial disease is associated with improved survival in patients with brain metastasis from hepatocellular carcinoma

  • Hee Chul Nam
  • Pil Soo Sung
  • Do Seon Song
  • Jung Hyun Kwon
  • Soon Woo Nam
  • Dong Jin Yoon
  • Jeong Won Jang
  • Jong Young Choi
  • Seung Kew Yoon
  • Seok Whan Moon
  • Hong Seok Jang
  • Jae-Sung Park
  • Sin-Soo Jeun
  • Yong-Kil Hong
  • Si Hyun BaeEmail author
Original Article
  • 111 Downloads

Abstract

Background

Brain metastasis is a rare event in patients with hepatocellular carcinoma (HCC). This retrospective study aimed to identify the prognostic factors and determine the outcomes of patients with brain metastases from HCC.

Methods

About 86 patients with brain metastases (0.6%) from HCC were identified from two institutions; of them, 32 underwent tumor-removing surgery or stereotactic radiosurgery (SRS) with or without adjuvant whole brain radiotherapy (WBRT) (group 1), 30 had WBRT alone (group 2), and 24 received conservative treatment (group 3). Estimates for overall survival (OS) after brain metastases were determined, and clinical prognostic factors were identified.

Results

The median OS after development of brain metastases was 50 days. About 75 (87.2%) patients had lung metastases at the time of brain metastasis diagnosis. Group 1 showed better OS, followed by group 2 and group 3, sequentially (p < 0.001). Univariate analyses showed that treatment with curative intent (surgery or SRS), Child–Pugh class A, alpha-fetoprotein level < 400 ng/ml, and recursive partitioning analysis classification I or II were associated with improved survival (p < 0.001, 0.002, 0.029, and 0.012, respectively). Multivariate analysis showed that treatment with curative intent and Child–Pugh class A was associated with improved OS (p < 0.001 and 0.009, respectively).

Conclusion

Although the overall prognosis of patients with brain metastases from HCC is extremely poor, patients actively treated with surgery or radiosurgery have prolonged survival, suggesting that interventions to control intracranial disease are important in these patients.

Keywords

Hepatocellular carcinoma Brain metastasis Overall survival 

Notes

Acknowledgements

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (2017R1A2B4010197) (S.H.B.). This work was also supported by Research Fund of Seoul St. Mary’s Hospital, the Catholic University of Korea (P.S.S.).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests.

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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Hee Chul Nam
    • 1
    • 2
  • Pil Soo Sung
    • 1
    • 2
  • Do Seon Song
    • 2
  • Jung Hyun Kwon
    • 2
    • 3
  • Soon Woo Nam
    • 2
    • 3
  • Dong Jin Yoon
    • 1
  • Jeong Won Jang
    • 1
    • 2
  • Jong Young Choi
    • 1
    • 2
  • Seung Kew Yoon
    • 1
    • 2
  • Seok Whan Moon
    • 4
  • Hong Seok Jang
    • 5
  • Jae-Sung Park
    • 6
  • Sin-Soo Jeun
    • 6
  • Yong-Kil Hong
    • 6
  • Si Hyun Bae
    • 2
    • 7
    Email author
  1. 1.Department of Internal Medicine, College of Medicine, Seoul St. Mary’s HospitalThe Catholic University of KoreaSeoulSouth Korea
  2. 2.The Catholic Liver Research Center, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
  3. 3.Department of Internal Medicine, College of Medicine, Incheon St. Mary’s hospitalThe Catholic University of KoreaSeoulSouth Korea
  4. 4.Department of Thoracic and Cardiovascular Surgery, College of MedicineSeoul St. Mary’s Hospital, The Catholic University of KoreaSeoulSouth Korea
  5. 5.Department of Radiation Oncology, College of MedicineSeoul St. Mary’s Hospital, The Catholic University of KoreaSeoulSouth Korea
  6. 6.Department of Neurosurgery, College of MedicineSeoul St. Mary’s Hospital, The Catholic University of KoreaSeoulSouth Korea
  7. 7.Department of Internal Medicine, College of Medicine, St. Paul’s HospitalThe Catholic University of KoreaSeoulSouth Korea

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