[The incidence and clinical significance of paraneoplastic syndromes in patients with hepatocellular carcinoma].
OBJECTIVE
Patients with hepatocellular carcinoma (HCC) may manifest paraneoplastic syndromes such as hypercholesterolemia, hypoglycemia, hypercalcemia and erythrocytosis. This study was aimed at evaluating the incidence and clinical significance of paraneoplastic syndromes in Korean HCC patients.


METHODS
The medical records of 165 HCC patients who were diagnosed and died in the Kyung Hee University Hospital, were reviewed retrospectively. The following variables were analyzed: age, gender, hepatitis markers, platelet, liver function test, alpha-fetoprotein (AFP), Child-Pugh score, tumor features, and the duration of their survival.


RESULTS
In total, paraneoplastic syndromes were presented in 43.6% of the HCC patients during the course of their disease. Hypercholesterolemia was solely presented in 14.5%, hypoglycemia in 12.7% and hypercalcemia in 7.8%. The patients who presented with more than 2 syndromes were 8.5%. While 80% of erythrocytosis (4/5) and 51.6% of hypercholesterolemia (16/31) was presented at the time of HCC diagnosis, hypoglycemia and hypercalcemia mainly occurred as terminal events. The patients with paraneoplastic syndromes were younger and had higher rates of portal vein thrombosis, bi-lobar tumor involvement and tumor more of more than 10 cm in diameter, compared to those patients without them. The proportion of patients with a serum AFP more than 400 ng/mL tended to be higher in the patients with paraneoplastic syndromes. The HCC patients with paraneoplastic syndromes, except for erythrocytosis, had a shorter survival than those patients without them.


CONCLUSIONS
Paraneoplastic syndromes are not infrequently presented in HCC patients, especially at an advanced stage, and the survival of these patients is relatively shorter.
Huh
Uh Young
UY
Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea.
Kim
Jin Hyuk
JH
Kim
Byung-Ho
BH
Nam
Ki Deuk
KD
Jang
Jae Young
JY
Kim
Nam Hoon
NH
Lee
Sang Kil
SK
Joo
Kwang Ro
KR
Dong
Seok Ho
SH
Kim
Hyo Jong
HJ
Chang
Young Woon
YW
Lee
Joung Il
JI
Chang
Rin
R
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000150:complications / Q000175:diagnosis