Prognostic analysis of pulmonary metastases from hepatocellular carcinoma.
OBJECTIVE
To analyze the prognostic factors for the patients with lung metastases from hepatocellular carcinoma (HCC).


METHODS
One hundred and five patients with lung metastases from HCC were analyzed retrospectively. We analyzed the impact factors, including the gender, age, liver function, serum AFP and gamma-GT level, the status of intrahepatic tumor and pulmonary metastases and treatment for them, the distant metastases beyond the lung, as well as the causes of death. The overall cumulative probability of survival was calculated by the Kaplan-Meier method, and the difference between the groups was compared using the Log-rank test. Univariate and multivariate analyses using the Cox-regression proportional hazard model were performed to evaluate the prognostic parameters for survival.


RESULTS
The survival after the lung metastases was influenced by clinical parameters, such as the status and the treatment for both the intrahepatic tumor and the pulmonary lesions. The causes of death were respiratory failure due to metastatic lesions from HCC in 16 patients (20.0%), liver failure caused by the progressive intrahepatic lesions in 54 (67.5%). The mean and median survival times were 684 and 487 days after HCC diagnosis and 264 and 179 days after lung metastases, respectively.


CONCLUSIONS
It was very important to treat the intrahepatic tumor because its worsening was still the major cause of death. The progressive treatment for pulmonary metastases may also be advised for possible prolongation of survival.
Zhang
Shu-Min
SM
Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China, zhangsmfudan@yahoo.com.cn.
Zeng
Zhao-Chong
ZC
Tang
Zhao-You
ZY
Sun
Jing
J
Cheng
Jie-Min
JM
Liu
Rong
R
Wang
Ping
P
Zhang
Bo-Heng
BH