title: [Outcome of Pulmonary Metastasectomy for Hepatocellular Carcinoma].
abstract: Pulmonary metastasis of hepatocellular carcinoma (HCC) is considered a poor prognostic feature of the disease, and the utility of pulmonary resection is unclear. We evaluated clinical outcomes following pulmonary resection in 7 patients. All patients underwent video-assisted thoracic surgery (VATS). The median disease-free interval (DFI) was 14 (6-23) months. During pulmonary resection in 1 of the patients, intrahepatic recurrence was discovered and, 18 months later, this patient died of the recurrence. Of the remaining 6 patients, 2 patients developed intrahepatic recurrence and brain metastasis and died at 66 months and 10 months after pulmonary resection. Three patients are still alive and disease-free to date with a median follow-up duration of 42 (18-55) months. Of these 3 surviving patients, 2 patients had solitary pulmonary metastases and 1 patient had multiple bilateral pulmonary metastases; these patients underwent VATS once. The 7th patient underwent VATS 3 times for pulmonary metastasis and had no evidence of intrahepatic or extrahepatic recurrence. This patient died of an unrelated cause 15 months after the last pulmonary resection (47 months after the primary pulmonary resection). This study indicates that surgical resection of metachronous pulmonary metastases is associated with a favorable outcome in selected patients.
authors.affiliation: Dept. of Surgery, Hiroshima City Hiroshima Citizens Hospital.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Ogawa
authors.forename: Daisuke
authors.initials: D
authors.lastname: Satoh
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Matsukawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Araki
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Shiozaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanazawa
authors.forename: Masao
authors.initials: M
authors.lastname: Harano
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Ojima
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Idani
authors.forename: Masazumi
authors.initials: M
authors.lastname: Okajima
authors.forename: Motoki
authors.initials: M
authors.lastname: Ninomiya
authors.forename: Toshiya
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Motoki
authors.initials: M
authors.lastname: Matsuura
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000628:therapy; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology* / Q000628:therapy; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D011013:Pneumonectomy; D016896:Treatment Outcome