Bone Metastases From Hepatocellular Carcinoma:Clinical Features And Prognostic Factors

Objectives:Bone metastases(BMs)arising from hepatocellular carcinoma(HCC)are an increasingly common disease in Asia.We assessed the clinical features,prognostic factors,and differences in clinical data related to BMs among patients given different treatments for HCC.Methods:Forty-three consecutive patients who were diagnosed with BMs from HCC between January 2010 and December 2014 were retrospectively enrolled.The clinical features were identified,the impacts of prognostic factors on survival were statistically analysed,and clinical data were compared among patients.Results:The median patient age was 54 years;38 patients were male and 5 were female.The most common site for BMs was the trunk(74.0%).BMs with extension to the soft tissue were found in 14 patients(32.5%).Most(90.7%)of the lesions were mixed osteolytic and osteoblastic,and most(69.8%)patients presented with multiple BMs.The median survival after BMs diagnosis was 11 months.In multivariate analyses,survival after BM diagnosis was correlated with Karnofsky performance status(P=0.008)and the Child-Pugh classification(P<0.001).BM-free survival was correlated with progression beyond the University of California San Francisco criteria(P<0.001)and treatment of primary tumours(P<0.001).BMs with extension to soft tissue were less common in liver transplantation patients.During metastasis,the control of intrahepatic tumours was improved in liver transplantation and hepatectomy patients,compared to conservatively treated patients.Conclusions:The independent prognostic factors of survival after diagnosis of BMs were the Karnofsky performance status and Child-Pugh classification.HCC patients who developed BMs may also benefit from liver transplantation or hepatectomy.