Top

International Journal of Clinical Oncology

Published in:

01-12-2018 | Original Article

Clinical outcomes of brain metastases from hepatocellular carcinoma: a multicenter retrospective study and a literature review

Authors: Takeshi Okuda, Nakamasa Hayashi, Masamichi Takahashi, Takeo Uzuka, Yoshiko Okita, Ryohei Otani, Toshiyuki Fujinaka, Mitsugu Fujita, Amami Kato, Yoshitaka Narita, Yoko Nakasu

Published in: International Journal of Clinical Oncology | Issue 6/2018

Abstract

Introduction

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.

Methods

We carried out a multicenter retrospective study to verify the characteristics of brain metastases from hepatocellular carcinoma in Japan.

Results

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.

Conclusions

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.

Llovet JM, Burroughs A, Bruix J (2003) Hepatocellular carcinoma. Lancet 362:1907–1917CrossRef

Forner A, Llovet JM, Bruix J (2012) Hepatocellular carcinoma. Lancet 379:1245–1255CrossRef

Kalogeridi MA, Zygogianni A, Kyrgias G et al (2015) Role of radiotherapy in the management of hepatocellular carcinoma: a systematic review. World J Hepatol 7:101–112CrossRef

Llovet LM, Ricci S, Mazzafenzo V et al (2008) Sorafenib in advanced hepatocellular carcinoma. N Engl Med 359:378–390CrossRef

Wang S, Wang A, Lin J et al (2017) Brain metastases from hepatocellular carcinoma: recent advances and future avenues. Oncoterget 8:25814–25829

Committee of Brain Tumor Registry of Japan (2017) Report of brain tumor Registry of Japan (2005–2008), vol 14. Neurol Med Chir (Tokyo) 57:1–102

Johnson PJ, Berhane S, Kagebayashi C et al (2015) Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach—the ALBI grade. J Clin Oncol 33:550–558CrossRef

Gasper L, Scott C, Rotman M et al (1997) Recursive partitioning analysis (RPA) of prognostic factors in three radiation therapy oncology group (RTOG) brain metastases trials. Int J Radiat Oncol Biol Phys 37:745–751CrossRef

Okuda T, Tasaki T, Nakata S et al (2017) Efficacy of combination therapy with MET and VEGF inhibitors for MET-overexpressing glioblastoma. Anticancer Res 37:3871–3876PubMed

10.

Choi HJ, Cho BC, Sohn JH et al (2009) Brain metastases from hepatocellular carcinoma: prognostic factors and outcome. J Neurooncol 91:307–313CrossRef

11.

Jiang XB, Ke C, Zhang GH et al (2012) Brain metastases from hepatocelullar carcinoma: clinical features and prognostic factors. BMC Cancer 12:49CrossRef

12.

Park ES, Kwon H, Park JB et al (2014) Gamma knife surgery for treating brain metastases arising from hepatocellular carcinomas. J Neurosurg 121:102–109CrossRef

13.

Kim KS, Kim K, Chie EK et al (2015) Post-treatment intracranial hemorrhage of brain metastases from hepatocellular carcinoma. Radiat Oncol 33:36–41CrossRef

14.

Park Y, Kim KS, Kim K et al (2015) Nomogram prediction of survival in patients with brain metastases from hepatocellular carcinoma treated with whole-brain radiotherapy: a multicenter retrospective study. J Neurooncol 125:377–383CrossRef

15.

Uka K, Aikata H, Takaki S et al (2007) Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma. World J Gastroenterol 13:414–420CrossRef

16.

Kim KS, Kim K, Chie EK et al (2014) Prognostic stratification of brain metastases from hepatocellular carcinoma. J Neurooncol 120:209–214CrossRef

17.

Lim S, Lee S, Lim JY et al (2014) Hepatocellular carcinoma specific graded prognostic assessment can predict outcomes for patients with brain metastases from hepatocellular carcionoma. J Neurooncol 120:199–207CrossRef

18.

Lieu AS, Hwang SL, Howng SL et al (1999) Brain tumors with hemorrhage. J Formos Med Assoc 98:365–367PubMed

19.

Yamakawa Y, Moriguchi M, Aramaki T et al (2015) Brain metastases from hepatocellular carcinoma: the impact of radiotherapy on control of intracranial hemorrhage. Hepatol Res 45:1071–1075CrossRef

20.

Brown PD, Jaeckle K, Ballman KV et al (2016) Effect of radiosurgery alone vs radiosurgery with whole brain radiation therapy on cognitive function in patients with 1 to 3 brain metastases. JAMA 316:401–409CrossRef

21.

Brown PD, Ahluwalia MS, Khan OH et al (2018) Whole-brain radiotherapy for brain metastases: evolution or revolution? J Clin Oncol 36:483–491CrossRef

22.

Mulvenna P, Nankivell M, Barton R et al (2016) Dexamethasone and supportive care with or without whole brain radiotherapy in treating patients with non-small cell lung cancer with brain metastases unsuitable for resection or stereotactic radiotherapy (QUARTZ): results from a phase 3, non-inferiority randomized trial. Lancet 388:2004–2014CrossRef

Title: Clinical outcomes of brain metastases from hepatocellular carcinoma: a multicenter retrospective study and a literature review
Authors: Takeshi Okuda
Nakamasa Hayashi
Masamichi Takahashi
Takeo Uzuka
Yoshiko Okita
Ryohei Otani
Toshiyuki Fujinaka
Mitsugu Fujita
Amami Kato
Yoshitaka Narita
Yoko Nakasu
Publication date: 01-12-2018
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 6/2018
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-018-1312-5

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2018

Colorectal obstruction is a potential prognostic factor for stage II colorectal cancer

Definitive chemoradiotherapy for anal canal cancer: single-center experience

Effect of everolimus treatment for regrown renal angiomyolipoma associated with tuberous sclerosis complex after transcatheter arterial embolization

Longitudinal changes in the quality of life of oral cancer patients during the perioperative period

Nationwide Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 Seed Implantation (J-POPS): first analysis on survival

A phase II study of carboplatin, pemetrexed, and bevacizumab followed by erlotinib and bevacizumab maintenance for non-squamous non-small cell lung cancer with wild-type EGFR (HOT1101)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer