Prognostic factors for pulmonary metastasectomy in hepatocellular carcinoma.
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.
Kuo
Shuenn-Wen
SW
Department of Surgery and Traumatology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, 100, Taiwan.
Chang
Yih-Leong
YL
Huang
Pei-Ming
PM
Hsu
Hsao-Hsun
HH
Chen
Jin-Shin
JS
Lee
Jang-Ming
JM
Lee
Po-Huang
PH
Lee
Yung-Chie
YC
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