title: Pure transcatheter arterial chemoembolization therapy for intrahepatic tumors causes a shrink in pulmonary metastases of hepatocellular carcinoma.
abstract: OBJECTIVE
  Pulmonary metastasis of hepatocellular carcinoma (HCC) could be defined as advanced HCC and systematic treatment is the main therapeutic modality. However, local therapy of intrahepatic tumor, which is significantly associated with the prognosis of HCC, remains important for advanced HCC.
  
  
  METHODS
  Twenty-six HCC patients with pulmonary metastasis underwent intrahepatic transcatheter arterial chemoembolization (TACE). We investigated the progression of lung metastastic tumors, overall survival and risk factors related to survival of these patients.
  
  
  RESULTS
  Of the 26 patients who underwent TACE for one to four times, 10 patients achieved complete remission (CR) of intrahepatic tumors and among these 10 patients, 4 patients successfully received hepatic artery-venous shunt embolization combined with TACE. The lung metastasis lesions also achieved CR and the survival time was significantly longer than the other 22 patients. The lung metastastic lesions of the other 6 patients of intrahepatic tumors achieved stable disease (SD). Six patients acquired partial remission (PR) of intrahepatic tumors after TACE, while the lung metastastic lesions showed SD or progress disease (PD). Patients who showed CR and PR of intrahepatic tumors had longer survival time than patients with SD and PD. Portal vein tumor thrombus and size of the lung metastastic lesions were significant prognostic factors in these advanced HCC patients.
  
  
  CONCLUSIONS
  With respect to HCC patients with lung metastasis, TACE was an effective and important therapeutic tool to control pulmonary metastatic tumor growth, and prolong the survival of advanced HCC patients, especially patients with hepatic artery-venous shunt.
authors.affiliation: Department of Interventional Radiology, Shandong Cancer Hospital Jinan, Shandong, China.
authors.forename: Huiyong
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital Jinan, Shandong, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Thoracic Surgery, Shandong Cancer Hospital Jinan, Shandong, China.
authors.forename: Shuguang
authors.initials: S
authors.lastname: Liu
authors.affiliation: PET-CT Center, Shandong Cancer Hospital Jinan, Shandong, China.
authors.forename: Jinsong
authors.initials: J
authors.lastname: Zheng
authors.affiliation: B-ultrasound Room, Shandong Cancer Hospital Jinan, Shandong, China.
authors.forename: Guanglei
authors.initials: G
authors.lastname: Ji
authors.affiliation: Department of Interventional Radiology, Shandong Cancer Hospital Jinan, Shandong, China.
authors.forename: Yinfa
authors.initials: Y
authors.lastname: Xie
keywords: Transcatheter arterial chemoembolization therapy; hepatocellular carcinoma; intrahepatic tumor; pulmonary metastasis