Therapeutic significance and indications of pulmonary metastasectomy for hepatocellular carcinoma following liver resection

INTERNATIONAL JOURNAL OF SURGERY

卷:48

Article

Hu, Zhigang^1,2,3  Li, Wenbin²  Huang, Pinbo²  Zhou, Zhenyu^1,2  Xu, Junyao²  Xu, Kang²  Wang, Jie²  Zhang, Heyun^1,2 

[1] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Res Ctr Med, Guangdong Prov Key Lab Malignant Tumor Epigenet &, 107 Yanjiang West Rd, Guangzhou 510120, Guangdong, Peoples R China

[2] Sun Yat Sen Univ, Sun Yat Sen Mem Hosp, Dept Hepatobiliary Surg, 107 Yanjiang West Rd, Guangzhou 510120, Guangdong, Peoples R China

[3] Nanchang Univ, Affiliated Hosp 2, Dept Hepatobiliary Surg, 1 Minde Rd, Nanchang 330006, Jiangxi, Peoples R China

关键词: Hepatocellular carcinoma;    Pulmonary metastasis;    Pulmonary metastasectomy;    Liver resection;   

DOI  :  10.1016/j.ijsu.2017.09.075

来源: Elsevier

【 摘 要 】

Background: To explore the therapeutic significance and indications of pulmonary metastasectomy (PMT) in hepatocellular carcinoma (HCC) patients with pulmonary metastasis (PM) following liver resection (LR). Patients and methods: PM-HCC patients who underwent LR were retrospectively enrolled, and survival outcomes and prognostic factors were analyzed. Patients were divided into PMT and non-PMT group, and propensity score matching (PSM) analysis was used for survival comparison. Prognostic analysis and survival comparisons were performed specifically in PMT patients. Results: Ninety-seven patients were enrolled, among which twenty-six underwent PMT while seventy-one did not. Survival outcome was superior in PMT group compared to non-PMT group (33.5 vs. 10.5 months) (p = 0.003), while no statistical difference was found after PSM analysis (33.5 vs. 11.2 months) (p = 0.138). Synchronous PM-HCC, serum alpha fetal protein=400 ng/ml at PM diagnosis, no intrahepatic treatments (LR, ablation or transarterial chemoembolization) after LR, intrahepatic recurrence or metastasis at repeated PM diagnosis were inferior independent prognostic factors in PMT patients (p < 0.05). Superior survival outcomes were seen in candidate PMT patients when corresponding indications were satisfied (p = 0.014, p = 0.005). Conclusion: PMT might provide potential survival benefits in well selected PM-HCC patients who underwent LR. Well designed, multi-institutional studies with larger patient number were still to be required.

【 授权许可】

Free