title: Clinical outcome and prognostic factors in hepatocellular carcinoma patients with bone metastases medicated with zoledronic acid.
abstract: OBJECTIVE
  We retrospectively analyzed the clinical outcome and prognostic parameters in patients with hepatocellular carcinoma (HCC) and bone metastases who had received treatment with zoledronic acid (ZOL).
  
  
  METHODS
  Ninety-nine HCC patients with bone metastases who had been treated with ZOL were enrolled in this retrospective cohort study. We analyzed the prognostic factors, including serum N-telopeptide of type I collagen (NTX) levels, as bone metabolism markers.
  
  
  RESULTS
  The median overall survival (OS) time was 11.5 months. Child-Pugh grade A (P = 0.004) and intrahepatic tumor stage (IHTS) T0-3 (P = 0.010) correlated significantly with favorable OS. In 46 patients with grade A and T0-3, receiver operating characteristic curve analysis defined 16 nmol BCE/L serum NTX as the cut-off level for median OS. Multivariate analysis identified baseline serum NTX <16 nmol BCE/L (P = 0.045) as the only significant and independent determinant of OS.
  
  
  CONCLUSIONS
  Low baseline serum NTX level correlated with favorable outcome in bone metastatic HCC patients with Child-Pugh grade A and IHTS T0-3 treated with ZOL.
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Yohji
authors.initials: Y
authors.lastname: Honda
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Fumi
authors.initials: F
authors.lastname: Honda
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Norihito
authors.initials: N
authors.lastname: Nakano
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hatooka
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Morio
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fukuhara
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nagaoki
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Imamura
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Yoshiiku
authors.initials: Y
authors.lastname: Kawakami
authors.affiliation: Departments of Gastroenterology and Metabolism, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
keywords: HCC; bone metastasis; serum NTX; skeletal-related event; zoledronic acid