肝肿瘤细胞肺转移的外科切除: 原发灶控制与预后相关分析

Surgical resection for pulmonary metastasis from hepatocellular carcinoma: analysis of prognosis in relation to primary control.

机构信息

Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

J Surg Oncol. 2010 Mar 1;101(3):239-43. doi: 10.1002/jso.21487.

DOI:10.1002/jso.21487

PMID:20127898

Abstract

BACKGROUND

Advances in local treatments for hepatocellular carcinoma (HCC) have seen better prognosis. There were few studies on surgery for pulmonary metastasis from HCC controlled by local treatment. This study was conducted to analyze prognostic factors after surgery for pulmonary metastasis from HCC.

METHODS

We reviewed 32 patients who underwent surgery for pulmonary metastasis from HCC and analyzed prognostic factors.

RESULTS

HCC was controlled by surgery in 16 patients and by local treatment in 16 patients at the time of pulmonary resection. The median survival time after pulmonary resection was significantly better for HCC controlled by surgery, disease-free time >or=12 months, TMN stage I-II, and T factor 1-2 of primary HCC. The median survival time was better for lesion <or=2 and Child-Pugh score A, but they were not significant (P = 0.053, 0.069). In multivariate analysis, HCC controlled by surgical treatment (P = 0.008), and lesion <or=2 (P = 0.030) were independent prognostic factors.

CONCLUSION

Our Results indicated that surgical resection for pulmonary metastasis from HCC might be beneficial for patients whose HCC was controlled by surgery and the number of lesions was lower than 3.

摘要

背景

肝癌（HCC）局部治疗的进展使预后得到改善。对于接受局部治疗控制的 HCC 肺转移患者进行手术治疗的研究较少。本研究旨在分析 HCC 肺转移患者手术后的预后因素。

方法

我们回顾了 32 例接受 HCC 肺转移手术治疗的患者，并分析了预后因素。

结果

在肺切除时，16 例患者的 HCC 通过手术控制，16 例患者通过局部治疗控制。手术控制 HCC、无疾病时间>或=12 个月、TMN 分期 I-II 和原发性 HCC 的 T 因子 1-2 的患者，其术后中位生存时间明显更长。病变<或=2 和 Child-Pugh 评分 A 的患者的中位生存时间更好，但无统计学意义（P=0.053，0.069）。多因素分析显示，手术治疗控制 HCC（P=0.008）和病变<或=2（P=0.030）是独立的预后因素。