Hepatocellular carcinoma and musculoskeletal system: A narrative literature review

Figure 1 Role of musculoskeletal alterations in clinical management of patients with hepatocellular carcinoma. Various factors contribute to musculoskeletal decline in patients with hepatocellular carcinoma. A multiscale and multidisciplinary approach should be used to assess musculoskeletal health. aBMD: Areal bone mineral density; BMC: Bone mineral content; HCC: Hepatocellular carcinoma; FRAX: Fracture risk assessment tool; BTMs: Bone turnover markers; ALM: Appendicular lean mass; FFMA: Fat-free muscle area; PMI: Psoas muscle index; SMA: Skeletal muscle area; SMI: Skeletal muscle index.

Figure 2 Schematic representation of possible etiopathogenetic mechanisms of musculoskeletal alterations in patients with hepatocellular carcinoma. The possible roles of multiple factors leading to musculoskeletal alterations in patients with hepatocellular carcinoma are shown. HCC: Hepatocellular carcinoma; IGF-1: Insulin-like growth factor 1; FGF-2: Fibroblast-like growth factor 2; GH: Growth hormone; IL: Interleukin; PTH: Parathyroid hormone; OCN: Osteocalcin; SOST: Sclerostin; TNF: Tumor necrosis factor; VEGF: Vascular endothelial growth factor.