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Survival of patients with skeletal metastases from hepatocellular carcinoma after surgical management
Cited 14 time in
Web of Science
Cited 15 time in Scopus
- Authors
- Issue Date
- 2009-11
- Publisher
- BRITISH EDITORIAL SOC BONE JOINT SURGERY
- Citation
- JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME; Vol.91-B, No.11; 1505-1512
- Abstract
- Skeletal metastases from hepatocellular carcinoma are highly destructive vascular lesions
which severely reduce the quality of life. Pre-existing liver cirrhosis presents unique
challenges during the surgical management of such lesions. We carried out a retrospective
study of 42 patients who had been managed surgically for skeletal metastases from
hepatocellular carcinoma affecting the appendicular skeleton between January 2000 and
December 2006. There were 38 men and four women with a mean age of 60.2 years (46 to 77).
Surgery for a pathological fracture was undertaken in 30 patients and because of a high risk
of fracture in 12. An intralesional surgical margin was achieved in 36 and a wide margin in
six. Factors influencing survival were determined by univariate and multivariate analyses.
The survival rates at one, two and three years after surgery were 42.2%, 25.8% and 19.8%,
respectively. The median survival time was ten months (95% confidence interval 6.29 to 13.71).
The number of skeletal metastases and the Child-Pugh grade were identified as
independent prognostic factors by Cox regression analysis. The method of management of
the hepatocellular carcinoma, its status in the liver, the surgical margin for skeletal
metastases, the presence of a pathological fracture and adjuvant radiotherapy were not
found to be significantly related to the survival of the patient, which was affected by hepatic
function, as represented by the Child-Pugh grade.
- ISSN
- 0301-620X
- Language
- English
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