title: Prognostic factors for pulmonary metastasectomy in hepatocellular carcinoma.
abstract: OBJECTIVE
  To identify the prognostic factors for pulmonary metastasectomy (PM-ectomy) in hepatocellular carcinoma (HCC).
  
  
  METHODS
  We conducted a retrospective review of patients with pulmonary metastases (PM) from HCC who had undergone curative PM-ectomy at National Taiwan University Hospital between 1990 and 2004. Univariate (log-rank) and multivariate (Cox's model) analyses of survival were used to identify the significant prognostic factors.
  
  
  RESULTS
  In total, 34 patients were eligible for curative PM-ectomy. The overall survival rates (Kaplan-Meier) after PM-ectomy were 65.2% and 27.5% at 2 and 5 years, respectively. High alpha-fetoprotein level, positive hepatic resection margin, and short disease-free interval (DFI) were unfavorable factors for overall survival from univariate analysis, however, only DFI (P = 0.028) was identified as an independently prognostic factor by multivariate analysis. Bilateral distribution and more PMs were unfavorable factors for PM-free survival from univariate analysis, with only PM number identified as an independent prognostic factor by multivariate analysis (P = 0.017).
  
  
  CONCLUSIONS
  Patients with longer DFIs and fewer PMs can benefit from PM-ectomy in HCC.
authors.affiliation: Department of Surgery and Traumatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 100, Taiwan.
authors.forename: Shuenn-Wen
authors.initials: SW
authors.lastname: Kuo
authors.forename: Yih-Leong
authors.initials: YL
authors.lastname: Chang
authors.forename: Pei-Ming
authors.initials: PM
authors.lastname: Huang
authors.forename: Hsao-Hsun
authors.initials: HH
authors.lastname: Hsu
authors.forename: Jin-Shin
authors.initials: JS
authors.lastname: Chen
authors.forename: Jang-Ming
authors.initials: JM
authors.lastname: Lee
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
authors.forename: Yung-Chie
authors.initials: YC
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008175:Lung Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis