title: Surgical outcomes for pulmonary metastases from hepatocellular carcinoma.
abstract: BACKGROUND
  Although favourable prognosis following aggressive treatment of extrahepatic metastases from hepatocellular carcinoma (HCC) has been reported, surgical outcomes for pulmonary metastases are unclear.
  
  
  METHODS
  Sixty-one patients (2.6%) of 2297 registered with the Metastatic Lung Tumor Study Group of Japan between 1990 and 2006, who underwent surgery for pulmonary metastases from HCC, were retrospectively reviewed from the registry.
  
  
  RESULTS
  The overall 5-year survival rate was 32.2%. The prognosis was significantly better for < or =2 lesions than for > or =3 lesions (p=0.046), for < or =3 lesions than for > or =4 lesions (p=0.0070), and for < or =4 lesions than for > or =5 lesions (p=0.029). No other factors that influence outcomes were identified. A stepwise regression analysis showed three or less pulmonary metastases to be an independent factor for better prognosis (p=0.048).
  
  
  CONCLUSIONS
  With careful patient selection, comparatively good outcomes can be expected following surgical resection of pulmonary HCC metastases. Among them, patients with multiple metastases, if number of metastases is small such as four or less, can be expected to survive long after surgery.
authors.affiliation: Division of General Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan. kawamura@sc.itc.keio.ac.jp <kawamura@sc.itc.keio.ac.jp>
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kawamura
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Matsuguma
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Horio
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyoshi
authors.forename: Ken
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Takehiko
authors.initials: T
authors.lastname: Fujisawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Kobayashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000556:secondary* / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome