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Journal of Korean Neurosurgical Society 2010;47(5): 325-331.
doi: https://doi.org/10.3340/jkns.2010.47.5.325
Little Response of Cerebral Metastasis from Hepatocellular Carcinoma to Any Treatments.
Jung Ho Han, Dong Gyu Kim, Jung Cheol Park, Hyun Tai Chung, Sun Ha Paek, Young Seob Chung
1Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea.
2Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea.
3Department of Neurosurgery, Jeju University Hospital, Jeju, Korea.
4Department of Neurosurgery, Seoul National University Boramae Hospital, Seoul, Korea. yschung@snu.ac.kr
5Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
ABSTRACT
OBJECTIVE
We retrospectively evaluated the survival outcome of patients with brain metastasis from hepatocellular carcinoma (HCC).
METHODS
Between 1991 and 2007, a total of 20 patients were diagnosed as having brain metastasis from HCC. The mean age of the patients was 55 +/- 13 years, and 17 (85.0%) were men. Seventeen (85.0%) patients had already extracranial metastases. The median time from diagnosis of HCC to brain metastasis was 18.5 months. Fourteen (70.0%) patients had stroke-like presentation due to intracerebral hemorrhage (ICH). Ten (50.0%) patients had single or solitary brain metastasis. Among a total of 34 brain lesions, 31 (91.2%) lesions had the hemorrhagic components.
RESULTS
The median survival time was 8 weeks (95% CI, 5.08-10.92), and the actuarial survival rates were 85.0%, 45.0%, 22.5%, and 8.4% at 4, 12, 24, and 54 weeks. Age < 60 years, treatment of the primary and/or extracranial lesions, and recurrent ICH were the possible prognostic factors (p = 0.044, p < 0.001, and p = 0.111, respectively). The median progression-free survival (PFS) time was 3 months (95% CI, 0.95-5.05).
CONCLUSION
The overall survival of the patients with brain metastasis from HCC was very poor with median survival time being only 8 weeks. However, the younger patients less than 60 years and/or no extracranial metastases seem to be a positive prognostic factor.
Key Words: Brain metastasis; Hepatocellular carcinoma; Survival outcome; Prognostic factor
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