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Clinical Factors Predictive of a Better Prognosis of Pulmonary Metastasectomy for Hepatocellular Carcinoma.

Abstract

BACKGROUND

Lung is the most common site of extrahepatic metastasis of hepatocellular carcinoma (HCC). The aim of this study was to identify prognostic factors for pulmonary metastasectomy of HCC.

METHODS

103 patients who underwent pulmonary metastasectomy for HCC between January 2005 and December 2016 were retrospectively evaluated. Patient demographic data and characteristics of the primary tumors and pulmonary metastasis were investigated to identify factors significantly correlated with prognosis.

RESULTS

Of 103 patients, 75 (72.8%) had one site pulmonary metastasis, 22 (21.4%) had two, and six (5.8%) had three or more. Liver recurrence at the time of pulmonary metastasectomy was noted in 34 patients. The estimated 5-year overall survival (OS) rate was 38.5% after pulmonary metastasectomy. Univariate prognostic analysis showed that liver recurrence at the time of pulmonary metastasectomy, extent of resection, laterality of pulmonary metastasis, tumor location, number of metastatic sites, and metastatic tumor size were significantly associated with favorable OS after pulmonary metastasectomy. Multivariate analysis revealed that liver recurrence at the time of pulmonary metastasectomy and the number of metastatic sites were independent prognostic factors. Subgroup analysis with a combination of these two independent prognostic factors revealed 5-year OS rates for patients with zero, one, and two risk factors of 58.5%, 23.8%, and 0.0%, respectively.

CONCLUSIONS

Pulmonary metastasectomy is safe and effective treatment for well-selected patients with pulmonary metastasis of HCC. Liver recurrence at the time of pulmonary metastasectomy and the number of metastatic sites were identified as independent prognostic factors. The number of risk factors significantly influenced patient survival.

Authors+Show Affiliations

Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: lin.zongwu@zs-hospital.sh.cn.Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31445050

Citation

Wang, Lin, et al. "Clinical Factors Predictive of a Better Prognosis of Pulmonary Metastasectomy for Hepatocellular Carcinoma." The Annals of Thoracic Surgery, 2019.
Wang L, Ye G, Zhan C, et al. Clinical Factors Predictive of a Better Prognosis of Pulmonary Metastasectomy for Hepatocellular Carcinoma. Ann Thorac Surg. 2019.
Wang, L., Ye, G., Zhan, C., Sun, F., Lin, Z., Jiang, W., & Wang, Q. (2019). Clinical Factors Predictive of a Better Prognosis of Pulmonary Metastasectomy for Hepatocellular Carcinoma. The Annals of Thoracic Surgery, doi:10.1016/j.athoracsur.2019.06.086.
Wang L, et al. Clinical Factors Predictive of a Better Prognosis of Pulmonary Metastasectomy for Hepatocellular Carcinoma. Ann Thorac Surg. 2019 Aug 21; PubMed PMID: 31445050.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical Factors Predictive of a Better Prognosis of Pulmonary Metastasectomy for Hepatocellular Carcinoma. AU - Wang,Lin, AU - Ye,Guanzhi, AU - Zhan,Cheng, AU - Sun,Fenghao, AU - Lin,Zongwu, AU - Jiang,Wei, AU - Wang,Qun, Y1 - 2019/08/21/ PY - 2018/11/15/received PY - 2019/05/21/revised PY - 2019/06/24/accepted PY - 2019/8/25/entrez PY - 2019/8/25/pubmed PY - 2019/8/25/medline JF - The Annals of thoracic surgery JO - Ann. Thorac. Surg. N2 - BACKGROUND: Lung is the most common site of extrahepatic metastasis of hepatocellular carcinoma (HCC). The aim of this study was to identify prognostic factors for pulmonary metastasectomy of HCC. METHODS: 103 patients who underwent pulmonary metastasectomy for HCC between January 2005 and December 2016 were retrospectively evaluated. Patient demographic data and characteristics of the primary tumors and pulmonary metastasis were investigated to identify factors significantly correlated with prognosis. RESULTS: Of 103 patients, 75 (72.8%) had one site pulmonary metastasis, 22 (21.4%) had two, and six (5.8%) had three or more. Liver recurrence at the time of pulmonary metastasectomy was noted in 34 patients. The estimated 5-year overall survival (OS) rate was 38.5% after pulmonary metastasectomy. Univariate prognostic analysis showed that liver recurrence at the time of pulmonary metastasectomy, extent of resection, laterality of pulmonary metastasis, tumor location, number of metastatic sites, and metastatic tumor size were significantly associated with favorable OS after pulmonary metastasectomy. Multivariate analysis revealed that liver recurrence at the time of pulmonary metastasectomy and the number of metastatic sites were independent prognostic factors. Subgroup analysis with a combination of these two independent prognostic factors revealed 5-year OS rates for patients with zero, one, and two risk factors of 58.5%, 23.8%, and 0.0%, respectively. CONCLUSIONS: Pulmonary metastasectomy is safe and effective treatment for well-selected patients with pulmonary metastasis of HCC. Liver recurrence at the time of pulmonary metastasectomy and the number of metastatic sites were identified as independent prognostic factors. The number of risk factors significantly influenced patient survival. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/31445050/Clinical_Factors_Predictive_of_a_Better_Prognosis_of_Pulmonary_Metastasectomy_for_Hepatocellular_Carcinoma L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(19)31206-8 DB - PRIME DP - Unbound Medicine ER -