Prognostic Analysis of Surgical Resection for Pulmonary Metastasis from Hepatocellular Carcinoma

Yusuke Takahashi, Norihiko Ikeda, Jun Nakajima, Noriyoshi Sawabata, Masayuki Chida, Hirotoshi Horio, Sakae Okumura, Masafunmi Kawamura, Metastatic Lung Tumor Study Group of Japan The Metastatic Lung Tumor Study Group of Japan

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Abstract

Introduction: Pulmonary metastases are the most common among extrahepatic recurrences from hepatocellular carcinoma (HCC). It causes high risk of HCC-related death, despite recent progress in therapeutic options. However, a role of pulmonary metastasectomy as well as prognostic factors after metastasectomy has not been well established. We aimed to investigate survival outcomes and prognostic factors after pulmonary resection for metastases from HCC. Methods: A series of 93 patients who underwent pulmonary resections for metastases from HCC between June 1990 and July 2013 from multi-institutional database were retrospectively evaluated. Perioperative clinicopathological data and their association with prognosis were investigated. Results: Of 93 patients, 77 had one pulmonary metastasis, and 16 had two or more. Recurrence after pulmonary resection was noted in 60 patients (64.5 %). The estimated 5-year overall survival rate was 41.4 % with median survival time after pulmonary metastatectomy of 39.0 months. Univariate prognostic analysis showed that disease-free interval of ≥12 months was significantly associated with favorable outcomes in both overall survival (5-year rate, 59.3 vs. 28.7 %, p = 0.026) and disease-specific survival (5-year rate, 62.5 vs. 36.2 %; p = 0.038) after pulmonary metastatectomy. A multivariate analysis revealed that disease-free interval was an independent prognostic factor (HR = 2.020, 95 % CI, 1.069–3.816, p = 0.030). Conclusion: We have shown that a disease-free interval was an independent prognostic factor in patients who underwent pulmonary resection for metastasis from HCC. Also, pulmonary metastasectomy can be one of the therapeutic choices for select patients.

Original languageEnglish
Pages (from-to)2178-2185
Number of pages8
JournalWorld Journal of Surgery
Volume40
Issue number9
DOIs
Publication statusPublished - 2016 Sep 1

ASJC Scopus subject areas

  • Surgery

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    Takahashi, Y., Ikeda, N., Nakajima, J., Sawabata, N., Chida, M., Horio, H., Okumura, S., Kawamura, M., & The Metastatic Lung Tumor Study Group of Japan, M. L. T. S. G. O. J. (2016). Prognostic Analysis of Surgical Resection for Pulmonary Metastasis from Hepatocellular Carcinoma. World Journal of Surgery, 40(9), 2178-2185. https://doi.org/10.1007/s00268-016-3580-4