The influencing factors and survival rate of pulmonary metastasis after
liver resection :a retrospective cohort study
Background: Pulmonary metastasis(PM) form hepatocellular carcinoma(HCC)
is a major indicator of a poor prognosis after liver resection. The
study aimed to probe into the influencing factors for PM following open
liver resection(OLR) and laparoscopic liver resection(LLR) with HCC.
Method: All patients who suffered from LLR and OLR for primary HCC, who
developed pulmonary metastasis, as first extrahepatic metastasis, were
retrospectively analyzed in our department from January 2014 to August
2020. Results: Thirty-three cases were included (median age 50
years,81.8% male). The patients with a single tumor had 23 cases
(69.7%), and a total of 10 patients(30.3%) has two and more tumors. 21
cases (63.6%) were smaller than 10 cm of tumor diameter. The median of
operation time was 200 minutes (110-360), Portal vein occlusion occurred
in 12 patients(36.4%). Patients with intrahepatic recurrence received
vertebroplasty combined chemotherapy(VPCC), targeted therapy ,
trans-arterial chemo-embolization(TACE) and radio frequency catheter
ablation(RFCA) in 1(3%),1(3%),10(30.3%) and 7(12.1%) cases
respectively. The 2- and 3- year cumulative probability of overall
survival (OS) were 63% and 41%. The median OS was 30.8 months. The
median recurrence time was 6 months(1.7-4.8). The median of confirmed PM
time from HCC was 12.5 months(1.5-61.1) and 17(51.5%) patients died.
Conclusion: Early detection of intrahepatic recurrence and treatment can
prolong PM time and overall survival time.