Jadzic J, Djonic D. Hepatocellular carcinoma and musculoskeletal system: A narrative literature review. World J Gastroenterol 2024; 30(15): 2109-2117 [PMID: 38681992 DOI: 10.3748/wjg.v30.i15.2109]
Corresponding Author of This Article
Danijela Djonic, MD, PhD, Professor, Center of Bone Biology, Faculty of Medicine, University of Belgrade, Dr. Subotic 4/2, Belgrade 11000, Serbia. ddjonic@yahoo.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Apr 21, 2024; 30(15): 2109-2117 Published online Apr 21, 2024. doi: 10.3748/wjg.v30.i15.2109
Hepatocellular carcinoma and musculoskeletal system: A narrative literature review
Jelena Jadzic, Danijela Djonic
Jelena Jadzic, Danijela Djonic, Center of Bone Biology, Faculty of Medicine, University of Belgrade, Belgrade 11000, Serbia
Author contributions: Jadzic J conceptualized the study, wrote the initial draft, and conducted the visualization; Jadzic J and Djonic D acquired the data; Djonic D reviewed and edited the manuscript; and all authors read and approved the final version of the manuscript.
Supported bythe Ministry of Science of the Republic of Serbia, No. 451-03-1524/2023-04/18; and the Science Fund of the Republic of Serbia (IDEAS Program), No. 7749444, BoFraM Project.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Danijela Djonic, MD, PhD, Professor, Center of Bone Biology, Faculty of Medicine, University of Belgrade, Dr. Subotic 4/2, Belgrade 11000, Serbia. ddjonic@yahoo.com
Received: January 4, 2024 Peer-review started: January 4, 2024 First decision: January 27, 2024 Revised: February 7, 2024 Accepted: March 26, 2024 Article in press: March 26, 2024 Published online: April 21, 2024
Abstract
Musculoskeletal alterations in hepatocellular carcinoma (HCC) are less common than liver-related complications. However, they can significantly impact the quality of life and overall prognosis of patients with HCC. The main obstacle in the clinical assessment of HCC-induced musculoskeletal alterations is related to effective and timely diagnosis because these complications are often asymptomatic and unapparent during routine clinical evaluations. This narrative literature review aimed to provide a comprehensive overview of the contemporary literature related to the changes in the musculoskeletal system in patients with HCC, focusing on its clinical implications and underlying etiopathogenetic mechanisms. Osteolytic bone metastases are the most common skeletal alterations associated with HCC, which could be associated with an increased risk of low-trauma bone fracture. Moreover, previous studies reported that osteopenia, sarcopenia, and myosteatosis are associated with poor clinical outcomes in patients with HCC. Even though low bone mineral density and sarcopenia are consistently reported as reliable predictors of pretransplantation and post-transplantation mortality in HCC patients, these complications are frequently overlooked in the clinical management of patients with HCC. Taken together, contemporary literature suggests that a multidisciplinary approach is essential for early recognition and clinical management of HCC-associated musculoskeletal alterations to improve patient prognosis. Further research into the mechanisms and treatment options for musculoskeletal complications is warranted to enhance our understanding and clinical management of this aspect of HCC.
Core Tip: Musculoskeletal alterations have a powerful detrimental effect on the quality of life and prognosis of patients with hepatocellular carcinoma (HCC). The causes of HCC-induced musculoskeletal decline are complex and not yet fully understood. The biggest challenge in diagnosing HCC-related musculoskeletal changes is timely and effective diagnosis, as these alterations are often asymptomatic and may not be obvious during routine clinical evaluations. Therefore, a multidisciplinary approach to the clinical management of musculoskeletal alterations is essential in patients with HCC.
