TY - JOUR
T1 - Prognostic Analysis of Surgical Resection for Pulmonary Metastasis from Hepatocellular Carcinoma
AU - Takahashi, Yusuke
AU - Ikeda, Norihiko
AU - Nakajima, Jun
AU - Sawabata, Noriyoshi
AU - Chida, Masayuki
AU - Horio, Hirotoshi
AU - Okumura, Sakae
AU - Kawamura, Masafunmi
AU - The Metastatic Lung Tumor Study Group of Japan, Metastatic Lung Tumor Study Group of Japan
N1 - Funding Information:
We have shown that a DFI of 12 months or longer is an independent favorable prognostic factor in patients who underwent pulmonary resection for metastasis from HCC. It was supported by the fact that longer DFI of ≥12 months is significantly associated with better DSS as well. A possible advantage of our study is the relatively large number of cases, as this is the largest series to investigate outcomes of pulmonary resection for metastasis from HCC to date.
Publisher Copyright:
© 2016, Société Internationale de Chirurgie.
PY - 2016/9/1
Y1 - 2016/9/1
N2 - 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.
AB - 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.
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U2 - 10.1007/s00268-016-3580-4
DO - 10.1007/s00268-016-3580-4
M3 - Article
C2 - 27255943
AN - SCOPUS:84982272594
SN - 0364-2313
VL - 40
SP - 2178
EP - 2185
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 9
ER -