Patients
A total of 33 patients who suffered from LLR(n=6) and OLR(n=27) for
primary HCC, who developed pulmonary metastasis, as first extrahepatic
metastasis, were retrospectively analyzed in our department from January
2014 to August 2020.
The enhanced spiral computed tomography (CT) as the diagnostic criteria
of pulmonary metastasis was performed every 1 month during the first
6months and every 3 months thereafter. One case received chemotherapy
and one patient received TACE to prevent or postpone postoperative
recurrence of HCC. Other patients were reviewed regularly after surgery.
The patients who were pathological diagnosed with HCC accompanied by a
history of liver resection were incorporated into the study. We
eliminated the patients with the following criteria:(1) the surgical
methods were conversion from laparoscopic to laparotomy and
hand-assisted laparoscopic surgery;(2) first extrahepatic recurrence was
not lung;(3) primary lung tumor;(4) had a history of invasive treatment;
(5) incomplete case.
The date was assessed with preoperative factors(including age, sex,
underline liver disease, Child-Pugh score, tumor size and number, portal
vein thrombus),intraoperative
factors(duration
and number of portal vine occlusion, operation time),postoperative
therapy(including chemotherapy, targeted therapy, radiofrequency
ablation, TACE) ,laboratory inspection before PM(AFP, CA-199, neutrophil
count, lymphocyte count, monocyte count, eosinophils count, basophil
count),time of pulmonary metastasis and survival time and overall
survival rate. The tumor size was defined as the maximum diameter of a
single or the sum of maximum diameter of multiple tumors. We defined the
time
from the date of LLR or OLR to the date of death or last follow-up as
survival time. The time of PM was the time from the date of LLR or OLR
to the date of diagnosis of PM from HCC by CT.