Spine Tumor Center, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Study Design: A retrospective study of 36 patients with metastatic Hepatocellular carcinoma (HCC) of the mobile spine was performed by survival analysis.Objective: To discuss the factors which may affect outcomes of patients with HCC spinal metastases.Summary of Background Data: Hepatocellular carcinoma (HCC) is a rare tumor in western countries. However, HCC is common in Far East (Taiwan, Korea, mainland China), where the hepatitis B virus is epidemic. As the mean survival time of patients with HCC was largely increased in recent years, it is more common to come across a patient with epidural spinal cord compression caused by HCC spinal metastases in clinic nowadays.Methods: The univariate and multivariate analyses of various clinical factors were performed to identify independent variables that could predict prognosis. The survival rate was estimated by the Kaplan-Meier method, and differences were analyzed by the log-rank test. Factors with P values of ≤0.1 were subjected to multivariate analysis for survival rate by multivariate Cox proportional hazards analysis.Results: A total of 36 patients with metastatic HCC of the mobile spine were included in the study. Age(≤45/>45), duration of preoperative symptoms (<6m/≥6m), preoperative Frankel score(A-C/D-E), Tomita score(5-7/8-10), and bisphosphonate treatment were suggested as the potential prognostic factors through univariate analysis. However, as they were submitted to the multivariate Cox regression model, only did Tomita score be found as an independent prognostic factor.Conclusion: Tomita score no more than 7 is a favorable prognostic factor for HCC metastases in the mobile spine.