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A Systematic Review of Metastatic Hepatocellular Carcinoma to the Spine
- Publication Year :
- 2016
-
Abstract
- Background Hepatocellular carcinoma (HCC) frequently metastasizes to the spine. The impact of medical and/or surgical intervention on overall survival has been examined in a limited number of clinical studies, and herein we systematically review these data. Methods We performed a literature review using PubMed, Embase, CINAHL, and Web of Science to identify articles that reported survival, clinical outcomes, and/or prognostic factors associated with patients diagnosed with spinal metastases. The methodologic quality of each review was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses tool. Results There were 26 articles (152 patients) that met the inclusion criteria and were treated with either surgery, radiotherapy, chemotherapy, and/or observation. There were 3 retrospective cohort studies, 17 case reports, 5 case series, and 1 longitudinal observational study. Of the patients with known overall survival after diagnosis of spinal metastasis, survival at 3 months, 6 months, 1 year, 2 years, and 5 years was 95.2%, 83.0%, 28.6%, 2.0%, and 1.4%, respectively. The median survival after diagnosis of the metastasis was 0.7 months in the patients who received no treatment, 7 months in the patients treated with surgical intervention alone, 6 months for patients who received chemotherapy and/or radiation, and 13.5 months in the patients treated with a combination of surgery and medical management. All other clinical or prognostic parameters were of low or insufficient strength. Conclusions Patients diagnosed with HCC spinal metastasis have a 10.6-month overall survival. Further analysis of patients in prospective controlled trials will be essential to the development of treatment algorithms for these patients in the future.
- Subjects :
- Male
medicine.medical_specialty
Carcinoma, Hepatocellular
medicine.medical_treatment
Article
Metastasis
03 medical and health sciences
0302 clinical medicine
Model for End-Stage Liver Disease
Interquartile range
Internal medicine
medicine
Humans
Survival analysis
Spinal Neoplasms
business.industry
Liver Neoplasms
Retrospective cohort study
Middle Aged
medicine.disease
Survival Analysis
Surgery
Radiation therapy
Systematic review
Treatment Outcome
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....f827d7706711c2481be2c6956b75230a