title: Clinical manifestations and survival of patients with hepatocellular carcinoma and cardiac metastasis.
abstract: OBJECTIVE
  Antemortem diagnosis of hepatocellular carcinoma (HCC) with cardiac metastasis is uncommon. To clarify the clinical manifestation and survival of HCC patients with cardiac metastases, we initiated the present study.
  
  
  METHODS
  We retrospectively analyzed 48 HCC patients with metastases into cardiac cavity diagnosed antemortem. The baseline clinical characteristics, echocardiogram, treatment modality and the outcome data were collected.
  
  
  RESULTS
  The most common symptoms of cardiac metastasis included asymptomatic in 19 cases (39.5%), bilateral lower leg edema in 18 cases (37.5%) and exertional dyspnea in 15 cases (31.3%). The median and mean survival times from the time of diagnosis of cardiac metastasis were 102 days and 161 days, respectively. Compared with another cohort of 48 patients with age-, gender-, and stage-matched HCC patients without cardiac metastasis, the median survival in the cardiac metastasis group was similar to the control group (68 days) (P = 0.67). The cause of death was HCC in 29, hepatic failure in seven, multiple organ failure in four, gastrointestinal bleeding in three, sepsis in two, pulmonary embolism in one, respiratory failure in one, and acute myocardial infarction in one.
  
  
  CONCLUSIONS
  Hepatocellular carcinoma patients with cardiac metastases were in the advanced stages. These patients had limited survival from the diagnosis of cardiac metastases. The most common cause of death was related to HCC per se or the underlying liver disease. Only a few patients expired because of cardiac metastases.
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Liu
authors.forename: Yi-Lwun
authors.initials: YL
authors.lastname: Ho
authors.forename: Guan-Tarn
authors.initials: GT
authors.lastname: Huang
authors.forename: Ding-Shinn
authors.initials: DS
authors.lastname: Chen
authors.forename: Jin-Chuan
authors.initials: JC
authors.lastname: Sheu
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D002423:Cause of Death; D004417:Dyspnea / Q000209:etiology; D004487:Edema / Q000209:etiology; D005260:Female; D006338:Heart Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D007866:Leg; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography