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Clinical outcomes of brain metastases from hepatocellular carcinoma: a multicenter retrospective study and a literature review

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Abstract

Introduction

The introduction of systemic chemotherapy for advanced hepatocellular carcinoma in recent years has led to the prediction that cases of brain metastases from hepatocellular carcinoma will increase. However, because brain metastases from hepatocellular carcinoma are relatively rare, the characteristics of this pathology are poorly understood.

Methods

We carried out a multicenter retrospective study to verify the characteristics of brain metastases from hepatocellular carcinoma in Japan.

Results

A total of 38 patients were enrolled and patient characteristics were poor general condition in many patients due to the progression of primary cancers. Stereotactic radiosurgery/stereotactic radiotherapy alone was the most common treatment (39.5%), with best supportive care provided for 10.5%. Median survival was 6 months, the neurological death rate was 28%, and the rate of brain hemorrhage was high (39.5%). Overall survival was analyzed for correlations with age, etiology of chronic liver disease, albumin–bilirubin (ALBI) grade, RPA classification, control of the primary tumor, number of brain metastases, brain hemorrhage, surgical resection, and radiotherapy. In multivariate analysis, ALBI grade, number of brain metastases and brain hemorrhage showed statistically significant correlation.

Conclusions

A multivariate analysis extracted three items—ALBI grade, number of brain metastases, and brain hemorrhage—as prognostic factors for survival of brain metastases from hepatocellular carcinoma.

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Funding

This study has no financial support.

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Authors and Affiliations

  1. Department of Neurosurgery, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan

    Takeshi Okuda & Amami Kato

  2. Division of Neurosurgery, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan

    Nakamasa Hayashi & Yoko Nakasu

  3. Department of Neurosurgery and Neuro-Oncology, National Cancer Center, Chuo-ku, Tokyo, Japan

    Masamichi Takahashi & Yoshitaka Narita

  4. Department of Neurosurgery, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan

    Takeo Uzuka & Ryohei Otani

  5. Department of Neurosurgery, Osaka National Hospital, Osaka, Osaka, Japan

    Yoshiko Okita & Toshiyuki Fujinaka

  6. Department of Microbiology, Kindai University Faculty of Medicine, Osaka-Sayama, Osaka, Japan

    Mitsugu Fujita

Authors
  1. Takeshi Okuda
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  2. Nakamasa Hayashi
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  3. Masamichi Takahashi
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  4. Takeo Uzuka
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  5. Yoshiko Okita
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  6. Ryohei Otani
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  7. Toshiyuki Fujinaka
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  8. Mitsugu Fujita
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  9. Amami Kato
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  10. Yoshitaka Narita
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  11. Yoko Nakasu
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Corresponding author

Correspondence to Takeshi Okuda.

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The authors have no conflicts of interest to disclose.

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Okuda, T., Hayashi, N., Takahashi, M. et al. Clinical outcomes of brain metastases from hepatocellular carcinoma: a multicenter retrospective study and a literature review. Int J Clin Oncol 23, 1095–1100 (2018). https://doi.org/10.1007/s10147-018-1312-5

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  • DOI: https://doi.org/10.1007/s10147-018-1312-5

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