Abstract
We reviewed the clinical course of 18 patients with recurrent bone metastases after hepatic resection for hepatocellular carcinoma. We performed 249 operations for 209 patients and then on 151 patients who thereafter had a recurrence. 10 were treated for a liver recurrence, 4 for a synchronism recurrence in liver, and one with a metastatic lung tumor. Only 3 patients had bone metastases without recurrence in liver or lung. Diagnosis was done by CT 10, bone scintigram 12, MR 9, and autopsy 1. 10 patients showed abnormally high results of tumor marker. Symptoms were pain 13, numbness 1, tumor palpating 1, asymptomatic 3, and body paralysis in the lower part of the body in 10 patients. After radiotherapy was performed for 14 patients and symptom relaxation by opioid dosage for 4, the average duration of life after diagnosis was 5.1 months. There was no correlation between the quantity of radiation exposure and the prognosis after radiotherapy. Paralysis in the lower part of the body was accompanied by QOL deterioration and poor prognosis for patients with early diagnosis of vertebra metastasis. Early recurrence with metastases to the bone is a distinct possibility for high-risk patients. Informed consent which takes metastases to the bone into consideration is necessary for patients with recurrence in liver or lung.
