Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma
Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma
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DOI：
10.3748/wjg.v13.i3.414
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发表时间：
2007-01-21
影响因子：
4.3
通讯作者：
Chayama, Kazuaki
中科院分区：
文献类型：
--
作者：
Uka, Kiminori;Aikata, Hiroshi;Chayama, Kazuaki
目的：分析151例原发性肝细胞癌（HCC）肝外转移患者的临床特点和预后，并探讨其治疗策略。在诊断出HCC后，所有995例连续的HCC患者定期随访，（15.2%）的患者在原发性HCC的初始诊断时发现有肝外转移或在随访期间发生此类肿瘤。我们评估了他们的临床特征，预后和治疗策略。结果：肝外转移最常见的部位是肺（47%），其次是淋巴结（45%），骨（37%）和肾上腺（12%）。首次诊断肝外转移后6、12、24和36个月的累积生存率分别为44.1%、21.7%、14.2%和7.1%。中位生存时间为4.9个月（范围，0-37个月）。14例（11%）死于肝外肝癌，其余死于原发性肝癌或肝功能衰竭。死亡原因以肝内肝癌多见，肝外转移少。虽然大多数肝细胞癌肝外转移患者应主要接受原发性肝细胞癌的治疗，但在肝储备良好、肝内肿瘤分期（T0-T2）、无门静脉侵犯的肝细胞癌患者中，肝外转移的治疗可能会提高生存率。(c)2007年，WJG出版社。All rights reserved.
AIM: To assess the clinical features and prognosis of 151 patients with extrahepatic metastases from primary hepatocellular carcinoma (HCC), and describe the treatment strategy for such patients.METHODS: After the diagnosis of HCC, all 995 consecutive HCC patients were followed up at regular intervals and 151 (15.2%) patients were found to have extrahepatic metastases at the initial diagnosis of primary HCC or developed such tumors during the follow-up period. We assessed their clinical features, prognosis, and treatment strategies.RESULTS: The most frequent site of extrahepatic metastases was the lungs (47%), followed by lymph nodes (45%), bones (37%), and adrenal glands (12%). The cumulative survival rates after the initial diagnosis of extrahepatic metastases at 6, 12, 24, and 36 mo were 44.1%, 21.7%, 14.2%, 7.1%, respectively. The median survival time was 4.9 mo (range, 0-37 mo). Fourteen patients (11%) died of extrahepatic HCC, others died of primary HCC or liver failure.CONCLUSION: The prognosis of HCC patients with extrahepatic metastases is poor. With regard to the cause of death, many patients would die of intrahepatic HCC and few of extrahepatic metastases. Although most of HCC patients with extrahepatic metastases should undergo treatment for the primary HCC mainly, treatment of extrahepatic metastases in selected HCC patients who have good hepatic reserve, intrahepatic tumor stage (T0-T2), and are free of portal venous invasion may improve survival. (c) 2007 The WJG Press. All rights reserved.