title: Transcatheter arterial embolization treatment in patients with hepatocellular carcinoma and risk of pulmonary metastasis.
abstract: OBJECTIVE
  To investigate the relationship between transcatheter arterial embolization (TAE) and pulmonary metastasis in subjects with hepatocellular carcinoma (HCC).
  
  
  METHODS
  A total of 287 patients with HCC followed up for more than 1 week were included. 102 patients underwent transcatheter arterial embolization (TAE group) and 185 received conservative treatment (control group). The patients' chest x-rays and chest CT scans were examined for pulmonary metastasis.
  
  
  RESULTS
  Patients with TAE had a median survival of 19.3 months while that of the control group was only 10.0 months (P<0.05). Pulmonary metastasis occurred in 14 (13.7 %) patients in the TAE group and 14 (7.6 %) patients in the control group, there was no significant difference (P>0.05). The 1-year, 2-year and 5-year cumulative incidence of pulmonary metastasis was 11.8 %, 17.6 % and 24.0 % in the TAE group and 7.0 %, 13.0 % and 21.7 % in the control group, respectively (P>0.05). On the univariate analysis, tumor size, abnormal serum alanine aminotransferase levels and heterogeneity on sonography were significantly associated with pulmonary metastasis. However, on the multivariate analysis, only tumor size was significantly predictive of pulmonary metastasis.
  
  
  CONCLUSIONS
  TAE is effective on prolonging survival of patients with HCC. It does not significantly increase the risk of pulmonary metastasis. Tumor size is the only significant predictive factor associated with lung metastasis.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Mackay Memorial Hospital. 92, Sec. 2, Chung San North Road, Taipei, Taiwan, China. sheechan@ms2.mmh.org.tw
authors.forename: Shee-Chan
authors.initials: SC
authors.lastname: Lin
authors.forename: Shou-Chuan
authors.initials: SC
authors.lastname: Shih
authors.forename: Chin-Roa
authors.initials: CR
authors.lastname: Kao
authors.forename: Sun-Yen
authors.initials: SY
authors.lastname: Chou
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000556:secondary* / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy*; D008175:Lung Neoplasms / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors