Prognosis of hepatocellular carcinoma patients with extrahepatic metastasis and the controllability of intrahepatic lesions.
Although advanced hepatocellular carcinoma (HCC) with extrahepatic metastasis is recommended to be treated by a systemic chemotherapeutic agent without local treatment targeting the liver, studies reported that causes of death in these patients were mostly from progression of intrahepatic lesions. Thus, this study investigated prognosis and factors predicting survival in these patients so as to evaluate the role of local treatments against intrahepatic lesions when the patients already had extrahepatic metastasis. This retrospective study evaluated medical records of 277 patients with HCC and extrahepatic metastasis. The median survival was 5.9 months, and 257 patients died during the follow up. Factors affecting survival of HCC patients with extrahepatic metastasis were poor response to treatment of hepatic lesions (HR 2.207; 95% CI; p < 0.001), applying local treatment specifically targeting intrahepatic lesions (HR 0.591; 95% CI 0.436-0.803; p = 0.001), intrahepatic tumor size larger than 3 cm (HR 2.065; 95% CI 1.444-2.954; p < 0.001), and ECOG performance status 2 or higher (HR 1.543; 95% CI 1.057-2.253; p = 0.025). The patients with either complete or partial response to the therapy had 1- and 2-year survival rate of 48.8 and 12.1% whereas patient with either stable or progressive disease had 1-year survival rate of 11.4%. These results suggest that even in the HCC patients with extrahepatic metastasis, effective local treatment may still be beneficial for the survival especially in patients with acceptable performance status.
Department of Internal Medicine, Liver Cirrhosis Clinical Research Center, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Republic of Korea.
Jung Il
JI
Lee
Department of Internal Medicine, Liver Cirrhosis Clinical Research Center, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Republic of Korea.
Ja Kyung
JK
Kim
Department of Internal Medicine, Liver Cirrhosis Clinical Research Center, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Do Young
DY
Kim
Department of Internal Medicine, Liver Cirrhosis Clinical Research Center, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Sang Hoon
SH
Ahn
Department of Internal Medicine, Liver Cirrhosis Clinical Research Center, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Jun Yong
JY
Park
Department of Internal Medicine, Liver Cirrhosis Clinical Research Center, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Seung Up
SU
Kim
Department of Internal Medicine, Liver Cirrhosis Clinical Research Center, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Beom Kyung
BK
Kim
Department of Internal Medicine, Liver Cirrhosis Clinical Research Center, Severance Hospital, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea.
Kwang Hyub
KH
Han
Department of Internal Medicine, Liver Cirrhosis Clinical Research Center, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 135-720, Republic of Korea. LEEKS519@yuhs.ac.
Kwan Sik
KS
Lee
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D000970:Antineoplastic Agents
Hepatocellular carcinoma; Metastasis; Survival; Treatment