The Number Of Pulmonary Metastasis Lesions Influence On The Therapeutic Efficacy Of Hepatocellular Carcinoma With Pulmonary Metastasis

Objective:To explore that the number of pulmonary metastasis lesions influence on the therapeutic efficacy of hepatocellular carcinoma(HCC) with pulmonary metastasis. Methods:The clinicopathological data and follow-up data of 90 patients who were diagnosed as HCC with pulmonary metastasis from Department of Hepatobiliary Surgery of First Affiliated Hospital of Fujian Medical University and Mengchao Hepatobiliary Hospital of Fujian Medical University in September 1, 2003 to January 29, 2016 were analyzed retrospectively. 61 patients underwent hepatectomy, and the other 29 patients underwent transcatheter arterial chemoembolization(TACE). The 61 patients who underwent hepatectomy according to the number of pulmonary metastatic lesions were divided into group A(the number of pulmonary metastasis lesions ≤2) and group B(the number of pulmonary metastasis lesions ≥3), the other 29 patients who underwent TACE according to the number of pulmonary metastatic lesions were divided into group C(the number of pulmonary metastasis lesions ≤2) and group D(the number of pulmonary metastasis lesions ≥3).The differences between the four groups of patients were compared and analyzed in clinicopathological data and survival rates. Patients were followed up by telephone interview, outpatient examination and hospital examination until February 29, 2016. The counting data was analyzed by using Chi-square test or Fisher probabilities. The survival curve was plotted and the survival rate was calculated by Kaplan-Meier method. The differences of survival rates were compared by using Log-rank test. Results:Group A and group B patients had no differences in clinicopathologica data. Group C and group D patients had no differences in clinical data.The 1-, 2-, 3- year survival rates of patients after hepatectomy were 58.6%, 41.5% and 30.4%, respectively, and the median survival time was 19 months. The 1-, 2-, 3-year survival rates of patients after TACE were 29.3%, 17.6% and 5.9%, respectively, and the median survival time was 8 months. The 1-, 2-, 3- year survival rates of group A patients after hepatectomy were 66.3%, 47.6% and 39.7%, respectively, and the median survival time was 23 months. The 1-, 2-, 3- year survival rates of group B patients after hepatectomy were 50.3%, 35.2% and 22.0%, respectively, and the median survival time was 13 months. The survival rate in group A was higher than that in group B(P<0.05). The 1-, 2-, 3- year survival rates of group C patients after TACE were 48.2%, 32.1% and 16.1%, respectively, and the median survival time was 12 months. The 1-, 2-, 3-year survival rates of group D patients after TACE were 20.1%, 10.0% and 0.0%, respectively, and the median survival time was 5 months. The survival rate in group C was higher than that in group D(P<0.05). Conclusions:The HCC patients with the number of pulmonary metastasis lesions ≥3 who underwent hepatectomy or TACE had the poor therapeutic efficacy.