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Treatment outcomes of patients with spinal metastases derived from hepatocellular carcinoma

  • Hiroshi Uei
  • Yasuaki Tokuhashi
  • Masafumi Maseda
Original Article
  • 112 Downloads

Abstract

Background

The prognosis of hepatocellular carcinoma (HCC) used to be poor, but it has recently improved, which has meant that clinicians have greater opportunity to treat spinal metastases and the associated epidural spinal cord compression. However, there have been few systematic functional studies about HCC-derived spinal metastases. The treatment outcomes of surgical treatment for HCC-derived metastatic spinal tumors were investigated.

Methods

The post-treatment survival period and pain, paralysis, and disturbance of activities of daily living (ADL) were investigated in 60 patients (surgery 25, conservative treatment 35).

Results

The mean post-treatment survival period was 7.4 ± 8.2 months (range 0.3–36 months). Univariate analysis indicated that the following factors influenced survival: the patient’s general condition, presence/absence of major internal organ metastasis, serum albumin level, Child–Pugh classification, surgical treatment for spinal metastasis, and bone-modifying agent treatment. In the multivariate analysis of these 6 items, 3 significant factors were extracted: the patient’s general condition, the serum albumin level, and bone-modifying agent treatment. Pain significantly improved in both groups (p < 0.001). Paralysis did not change significantly in the surgical group (p = 0.575), but it was significantly aggravated in the conservative treatment group (p = 0.047). The ADL abilities of the surgical group improved significantly (p < 0.001).

Conclusion

Most patients exhibited poor survival. In the conservative treatment group, paralysis was significantly aggravated, and little improvement was seen in the patients’ ADL abilities. In the surgical group, the patients’ ADL abilities improved significantly, but their paralysis did not. Therefore, surgery should be actively performed for HCC-derived spinal metastasis whenever it is indicated.

Keywords

Metastatic spinal tumor Hepatocellular carcinoma Treatment outcome Barthel index Survival period Activities of daily living 

Notes

Acknowledgements

We would like to thank all of the members of staff at Nihon University Itabashi Hospital.

Funding

No support.

Compliance with ethical standards

Conflict of interest

No author has any conflict of interest.

Ethical approval

IRB approval from Nihon University Itabashi Hospital: RK-11209-8.

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Copyright information

© Japan Society of Clinical Oncology 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryNihon University School of MedicineTokyoJapan

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