Department of Neurosurgery, Kindai University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
Division of Neurosurgery, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan.
Int J Clin Oncol. 2018 Dec;23(6):1095-1100. doi: 10.1007/s10147-018-1312-5. Epub 2018 Jul 2.
The introduction of systemic chemotherapy for advanced hepatocellular carcinoma in recent years has led to the prediction that cases of brain metastases from hepatocellular carcinoma will increase. However, because brain metastases from hepatocellular carcinoma are relatively rare, the characteristics of this pathology are poorly understood.
We carried out a multicenter retrospective study to verify the characteristics of brain metastases from hepatocellular carcinoma in Japan.
A total of 38 patients were enrolled and patient characteristics were poor general condition in many patients due to the progression of primary cancers. Stereotactic radiosurgery/stereotactic radiotherapy alone was the most common treatment (39.5%), with best supportive care provided for 10.5%. Median survival was 6 months, the neurological death rate was 28%, and the rate of brain hemorrhage was high (39.5%). Overall survival was analyzed for correlations with age, etiology of chronic liver disease, albumin-bilirubin (ALBI) grade, RPA classification, control of the primary tumor, number of brain metastases, brain hemorrhage, surgical resection, and radiotherapy. In multivariate analysis, ALBI grade, number of brain metastases and brain hemorrhage showed statistically significant correlation.
A multivariate analysis extracted three items-ALBI grade, number of brain metastases, and brain hemorrhage-as prognostic factors for survival of brain metastases from hepatocellular carcinoma.
近年来，晚期肝细胞癌系统化疗的引入预测肝癌脑转移病例将会增加。然而，由于肝癌脑转移相对较少，因此对该病理学的特征了解甚少。
我们进行了一项多中心回顾性研究，以验证日本肝癌脑转移的特征。
共纳入 38 例患者，由于原发性癌症的进展，许多患者的一般状况较差。单纯立体定向放射外科/立体定向放射治疗是最常见的治疗方法（39.5%），10.5%的患者接受最佳支持治疗。中位生存时间为 6 个月，神经死亡率为 28%，脑出血率较高（39.5%）。对总生存率与年龄、慢性肝病病因、白蛋白-胆红素（ALBI）分级、RPA 分类、原发性肿瘤控制、脑转移瘤数量、脑出血、手术切除和放疗进行相关性分析。多变量分析中，ALBI 分级、脑转移瘤数量和脑出血与生存显著相关。
多变量分析提取出 ALBI 分级、脑转移瘤数量和脑出血三个项目作为肝癌脑转移患者生存的预后因素。
