From the Guidelines
Hepatocellular carcinoma (HCC) most commonly metastasizes to the lung, adrenal glands, peritoneum, and bone. According to the NCCN clinical practice guidelines in oncology, version 2.2021 1, these are the common sites of HCC metastasis. The metastatic pattern of HCC is influenced by its vascular nature and tendency to invade blood vessels, which leads to intrahepatic spread before distant metastasis occurs.
Key Metastasis Sites
- Lung: often the first site of distant spread due to venous drainage patterns from the liver
- Adrenal glands: a common site for metastasis, likely due to the rich blood supply
- Peritoneum: a less frequent site, but still a significant location for metastasis
- Bone: typically affects the vertebrae, ribs, and long bones, causing pain and pathological fractures Understanding these metastatic patterns is crucial for proper staging, treatment planning, and surveillance of HCC patients. Early detection of metastases significantly impacts treatment decisions, as patients with metastatic disease may require systemic therapies. The majority of patients diagnosed with HCC have advanced disease, and only a small percentage are eligible for potentially curative therapies, highlighting the importance of careful patient selection for treatment and patient engagement 1.
From the Research
Metastasis of Hepatocellular Carcinoma
- Hepatocellular carcinoma (HCC) commonly metastasizes to various organs, including:
- Lungs
- Lymph nodes
- Adrenal gland
- Bones, including the skull 2
- The metastasis of HCC can occur through different routes, but the most common sites of metastasis are the lungs, lymph nodes, and bones
- The prognosis of patients with metastatic HCC is generally poor, with a low five-year survival rate 3
Sites of Metastasis
- The lungs are a common site of metastasis for HCC, and metastases to the lungs can be detected using imaging techniques such as computed tomography (CT) or magnetic resonance imaging (MRI) 4
- Lymph nodes, particularly those in the abdominal and thoracic regions, can also be affected by metastatic HCC
- The adrenal gland and bones, including the skull, are other potential sites of metastasis for HCC 2
Diagnosis and Treatment
- The diagnosis of metastatic HCC is typically made using a combination of imaging techniques, such as CT or MRI, and biopsy or fine-needle aspiration 5, 4
- Treatment options for metastatic HCC are limited, and the prognosis is generally poor, but treatment with tyrosine kinase inhibitors (TKIs) or immune checkpoint inhibitors may be effective in some cases 3