Chang Yu-Cheng, Chiang Xu-Heng, Tseng Yu-Ting, Kuo Shuenn-Wen, Huang Pei-Ming, Lin Mong-Wei, Hsu Hsao-Hsun, Chen Jin-Shing
Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei 100225, Taiwan.
Department of Medical Education, National Taiwan University Hospital, Taipei 100225, Taiwan.
Cancers (Basel). 2024 Aug 29;16(17):3007. doi: 10.3390/cancers16173007.
Oligopulmonary metastases from primary liver tumors are typically treated surgically. We evaluated the clinical outcomes after lung metastasectomy in patients with pulmonary metastases from primary liver tumors. We retrospectively enrolled 147 consecutive patients with lung metastases from liver cancer who had undergone pulmonary metastasectomies at three medical centers between February 2007 and December 2020. All patients were pathologically confirmed to have lung metastases from liver cancer. Among the 147 patients, 110, 17, and 20 initially underwent surgical resection, radiofrequency ablation, and transcatheter arterial embolization, respectively. The 5-year overall survival (OS) in the study cohort was 22%. Univariate analysis revealed four factors associated with better OS: surgical resection as the initial primary liver tumor treatment ( = 0.004), a disease-free interval exceeding 12 months after the initial liver surgery ( = 0.036), a lower Model for End-Stage Liver Disease (MELD)-Na score (≤20) for liver cirrhosis ( = 0.044), and the absence of local liver tumor recurrence at the time of pulmonary metastasectomy ( = 0.004). Multivariate analysis demonstrated that surgical resection as the initial primary liver tumor treatment and lower MELD-Na scores significantly correlated with better OS. Our findings can assist thoracic surgeons in selecting suitable patients for surgery and predicting surgical outcomes.
原发性肝癌的少发肺转移瘤通常采用手术治疗。我们评估了原发性肝癌肺转移患者行肺转移瘤切除术后的临床结局。我们回顾性纳入了2007年2月至2020年12月期间在三个医疗中心接受肺转移瘤切除术的147例连续性肝癌肺转移患者。所有患者均经病理证实为肝癌肺转移。在这147例患者中，分别有110例、17例和20例最初接受了手术切除、射频消融和经导管动脉栓塞术。研究队列的5年总生存率（OS）为22%。单因素分析显示，与更好的OS相关的四个因素：手术切除作为原发性肝癌的初始治疗（P = 0.004）、初次肝脏手术后无病生存期超过12个月（P = 0.036）、终末期肝病（MELD）-钠评分较低（≤20）用于肝硬化（P = 0.044）以及肺转移瘤切除时无局部肝肿瘤复发（P = 0.004）。多因素分析表明，手术切除作为原发性肝癌的初始治疗和较低的MELD-钠评分与更好的OS显著相关。我们的研究结果可帮助胸外科医生选择合适的手术患者并预测手术结局。
