Efficacy of Percutaneous Cementoplasty for Bone Metastasis from Hepatocellular Carcinoma

Abstract

Objective: To assess the efficacy of percutaneous cementoplasty for painful bone metastasis from hepatocellular carcinoma (HCC). Methods: Cementoplasty was performed for 22 metastatic bone tumors in 13 patients. All patients had intractable pain and were diagnosed as metastatic bone tumor from HCC. The ostyneedle was inserted in the center of the site of bone metastasis under CT guidance. VAS score, Tokuhashi score and Frankel score were used for assessment of the efficacy of cementoplasty. We also assessed the response to treatment, adverse events and prognosis. Results: Only the VAS score, but not Tokuhashi and Frankel scores, improved after cementoplasty. Cementoplasty for painful bone metastasis provided relief of severe pain but did not improve prognosis, neurological function or survival. Eleven of 13 (85%) patients showed CR or PR and the mean pain-free period was 5 months, including a 10-month pain-free period in one case. No major complications were encountered. Conclusions: Percutaneous cementoplasty can provide pain relief and improvement of quality of life, though without survival benefits, for HCC patients with painful bone metastasis.

FDG positron emission tomography/computed tomography for the detection of extrahepatic metastases from hepatocellular carcinoma

“…Bone metastasis is painful and reduces the quality of life of patients. Thus, early detection of bone metastasis by PET–CT should allow early treatment of pain by radiotherapy, chemotherapy, radiofrequency ablation therapy, or cementoplasty 21 …”

Role of Supportive Care for Terminal Stage Hepatocellular Carcinoma

“…49 Brain metastasis from HCC is extremely rare. Choi et al carried out a retrospective review of 62 patients.…”

Percutaneous Cementoplasty in the Palliative, Multimodal Treatment of Primary Bone Tumors of the Distal Aspect of the Radius in Four Dogs

“…In the remaining 2 dogs, analgesic dose was reduced by the owners by about 25% without detectable change in PVF (Dog 2), and Dog 4 subjectively had an obvious improvement from a moderate lameness to a near‐complete resolution of lameness within 4 days after the procedure, but became severely lame after hunting 10 days post‐PC. These results do not reach the 90% success rate lasting for >1 year reported for VP in people, 22–25 but they are comparable to what has been reported for cementoplasty treating bone malignancies outside the vertebral column in humans 27,32,34 . The reason why VP shows better results might be related to the unique anatomy of the vertebrae, which will be discussed later in greater detail.…”

“…In case the lesion had been another primary or secondary bone tumor other than OSA, we would have expected a comparable effect in pain palliation. Regardless of the exact diagnosis, PC has been shown to be comparably effective in different types of primary and secondary bone tumor in people 27–32,34,35,54 …”