ISSN: 1837-9664Journal of Cancer
Global reach, higher impact
J Cancer 2024; 15(4):1021-1029. doi:10.7150/jca.88931 This issue Cite
Review
Paraneoplastic Cutaneous Manifestations of Hepatocellular Carcinoma. A Systematic Review and Meta-analysis
1. Division of Hematology and Medical Oncology, Department of Medicine, Jordan University Hospital and School of Medicine, the University of Jordan, Amman, Jordan.
2. School of Medicine, The University of Jordan, Amman, Jordan.
3. Division of Dermatology, Department of Medicine, Jordan university Hospital and school of Medicine, The University of Jordan, Amman, Jordan.
4. Division of Hepatology and gastroenterology, Department of Medicine, Jordan university Hospital and school of Medicine, The University of Jordan, Amman, Jordan.
5. Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON. Canada.
Abstract
Background: There remains a scarcity of published data on the clinical significance of paraneoplastic cutaneous manifestations in hepatocellular carcinoma (HCC).
Method: A systematic search of MEDLINE was performed in December 2022. Inclusion criteria comprised studies reporting on patients with HCC, who had paraneoplastic cutaneous manifestations. Outcomes of interests comprise survival and response to cancer-directed and/or skin directed therapy.
Results: A total of 48 studies comprising 60 HCC patients were included in the analysis. The most frequent reported skin abnormalities were dermatomyositis, pityriasis rotunda, and porphyria. Most patients presented with dermatomyositis had underlying viral hepatitis, while all reported porphyria and acanthosis cases were associated with metabolic causes of HCC, such as steatosis. Paraneoplastic skin changes were more common in patients with metastatic disease. Pityriasis Rotunda was associated with the lowest risk of death, (OR: 0.05, 95% CI: 0.003 to 0.89; p = 0.04), while dermatomyositis had a statistically significant higher risk of death (OR: 3.37, 95% CI: 1.01-12.1; p = 0.03). Most patients showed an improvement in their cutaneous abnormalities, following cancer-directed therapy.
Conclusion: Paraneoplastic cutaneous manifestations are reported more frequently in patients with a higher burden of disease, especially presence of metastases. Certain cutaneous manifestations have prognostic implication.
Keywords: Paraneoplastic syndromes, Cutaneous manifestations, Hepatocellular carcinoma, Liver cancer
Citation styles
