Prognosis of operative treatment for metastatic hepatocellular carcinoma of the spine

Developing and developed countries have been reported increasing numbers of hepatocellular carcinoma and increased rates of distant metastasis from hepatocellular carcinoma. Data regarding operative treatments and prognoses of hepatocellular carcinoma metastasis to the spine are lacking in the literature. We retrospectively reviewed 12 patients with hepatocellular carcinoma and metastasis to the spine who had spinal surgery between 1986 and 1996. All 12 patients had severe back pain preoperatively. Posterior surgery alone was performed on two patients, anterior surgery alone in six patients, and combined anterior and posterior surgery in four. Ten of the 12 patients experienced pain relief and their neurologic status was preserved or improved. We designed a new outcome assessment, a modified Prolo scale, to evaluate surgical outcome. Seven of the 12 patients had good or excellent results. Our sample size was limited and we could draw no definite conclusions regarding the prognoses of these patients or the value of surgical intervention; however, we think that operative treatment for spinal metastatic hepatocellular carcinoma lesions may improve quality of life, regardless whether the survival time is prolonged.