A Systematic Review of Metastatic Hepatocellular Carcinoma to the Spine

C. Rory Goodwin, Vijay Yanamadala, Alejandro Ruiz-Valls, Nancy Abu-Bonsrah, Ganesh Shankar, Eric W. Sankey, Christine Boone, Michelle J. Clarke, Mark Bilsky, Ilya Laufer, Charles Fisher, John H. Shin, Daniel M. Sciubba

Research output: Contribution to journalReview articlepeer-review

15 Scopus citations


Background Hepatocellular carcinoma (HCC) frequently metastasizes to the spine. The impact of medical and/or surgical intervention on overall survival has been examined in a limited number of clinical studies, and herein we systematically review these data. Methods We performed a literature review using PubMed, Embase, CINAHL, and Web of Science to identify articles that reported survival, clinical outcomes, and/or prognostic factors associated with patients diagnosed with spinal metastases. The methodologic quality of each review was assessed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses tool. Results There were 26 articles (152 patients) that met the inclusion criteria and were treated with either surgery, radiotherapy, chemotherapy, and/or observation. There were 3 retrospective cohort studies, 17 case reports, 5 case series, and 1 longitudinal observational study. Of the patients with known overall survival after diagnosis of spinal metastasis, survival at 3 months, 6 months, 1 year, 2 years, and 5 years was 95.2%, 83.0%, 28.6%, 2.0%, and 1.4%, respectively. The median survival after diagnosis of the metastasis was 0.7 months in the patients who received no treatment, 7 months in the patients treated with surgical intervention alone, 6 months for patients who received chemotherapy and/or radiation, and 13.5 months in the patients treated with a combination of surgery and medical management. All other clinical or prognostic parameters were of low or insufficient strength. Conclusions Patients diagnosed with HCC spinal metastasis have a 10.6-month overall survival. Further analysis of patients in prospective controlled trials will be essential to the development of treatment algorithms for these patients in the future.

Original languageEnglish (US)
Pages (from-to)510-517.e4
JournalWorld neurosurgery
StatePublished - Jul 1 2016


  • Hepatocellular carcinoma
  • Liver cancer
  • Spine metastasis
  • Surgery
  • Survival
  • Tumor

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


Dive into the research topics of 'A Systematic Review of Metastatic Hepatocellular Carcinoma to the Spine'. Together they form a unique fingerprint.

Cite this