Prognostic Factors Analyse Of Hepatectomy For Hepatocellular Carcinoma With Pulmonary Metastasis

Objective:To analyses the efficacy and prognostic factors after hepatectomy for hepatocellular carcinoma(HCC) with pulmonary metastasis.Methods:We retrospectively assessed the clinical opathologic data of 88 patients was diagnosed with HCC with pulmonary metastasis from the tumor Hospital of Guangxi Medical University from September 1,2004and December 31,2014. There were 29 patients undergone hepatectomy, and the other 59 patients were treated by transarterial chemoembolization. The overall survival of the two group were compared. Univarite analysis was used to analyse the clinical opathologic data of the treatment group. COX’s regression model of multivariate analysis was done in order to determine the independent risk factors which had influenced the outcome after hepatectomy for HCC with pulmonary metastasis.Results:In HR group, the OS rates of 1-,2-and3-year were 37.9%、 17.2%、3.4%,respectively, and the median survival time was 7 months. In transarterial chemoembolization group, the OS rates of 1-,2-and3-year OS rates were 15.3%、10.2%、0%, respectively, and the median survival time was 4.7months. There had significant differences between the treatment and control group (P<0.05). Univarite analysis showed that the related prognostic risk factors after hepatectomy for HCC with pulmonary metastasis associated with serum age (P=0.046)、maximum diameter of HCC(P= 0.028)、the number of HCC(P= 0.007)、vascular invasion(P0.000)、maximum diameter of pulmonary metastasis (P=0.000)、the envelope of HCC(P=0.001)、the tumor differentiation (P=0.000). Multivariate analysis showed that the independent prognostic risk factors after hepatectomy for HCC with pulmonary metastasis associated with vascular invasion(P0.000)、maximum diameter of pulmonary metastasis (P=0.000)、the envelope of HCC(P=0.001)、the tumor differentiation (P=0.000)Conclusions:1. It can prolong time to progression and overall survival of HCC with pulmonary metastasis. through palliative operation。 2. Serum Age=≥60% maximum diameter of HCC> 8cm、the number of HCC ≥2、combined vascular invasion、maximum diameter of pulmonary metastasis> 0.8cm、the incomplete envelope of HCC and the tumor differentiation are the related prognostic risk factors associated with poor prognosis after hepatectomy for HCC with pulmonary metastasis. 3. Combined vascular invasion、maximum diameter of pulmonary metastasis > 0.8cm、the incomplete envelope of HCC and the tumor differentiation are the independent prognostic risk factors associated with poor prognosis after hepatectomy for HCC with pulmonary metastasis.