title: Outcome and survival analysis of pulmonary metastasectomy for hepatocellular carcinoma.
abstract: OBJECTIVE
  The lung is the most common site for extrahepatic metastasis from hepatocellular carcinoma (HCC). We previously reported in a series of 20 patients that pulmonary metastasectomy for HCC is feasible in selected patients. The objective of this study was to re-evaluate the long-term outcomes and prognostic factors with an additional 25 patients.
  
  
  METHODS
  We retrospectively analyzed the records of 45 consecutive patients who underwent pulmonary metastasectomy due to HCC at our institution between 1990 and 2010.
  
  
  RESULTS
  Thirty-nine patients underwent hepatectomy or liver transplantation, whereas six patients underwent locoregional therapy for primary liver lesions. Twenty-seven patients died during a median 17.6-month follow-up period. The 2-year disease-free survival (DFS) was 19.5%. The 5-year overall survival (OS) was 40.9%. History of recurrence and serum des-gamma-carboxy prothrombin (DCP) level >40 mAU ml(-1) at initial pulmonary resection were unfavorably associated with OS in univariate analysis.
  
  
  CONCLUSIONS
  Pulmonary metastasectomy for HCC in selected patients resulted in relatively good outcomes with regard to OS. History of recurrence and serum DCP levels were shown to be candidates of prognostic factors for OS.
authors: Department of Cardiothoracic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. ken-tky@umin.net
authors: Kentaro
authors: K
authors: Kitano
authors: Tomonori
authors: T
authors: Murayama
authors: Miki
authors: M
authors: Sakamoto
authors: Kazuhiro
authors: K
authors: Nagayama
authors: Katsuhito
authors: K
authors: Ueno
authors: Tomohiro
authors: T
authors: Murakawa
authors: Jun
authors: J
authors: Nakajima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D004812:Epidemiologic Methods; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery; D008297:Male; D059146:Metastasectomy / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011013:Pneumonectomy / Q000379:methods; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; C008208:acarboxyprothrombin; D011516:Prothrombin