Appraisal of Surgical Treatment for Pulmonary Metastasis from Hepatocellular Carcinoma

Abstract

The outcome of pulmonary metastasectomy of hepatocellular carcinoma (HCC) was appraised in this study. Twenty patients with pulmonary metastasis from HCCs undergoing pulmonary resection between 1990 and 2003 were included in this study. They had undergone curative treatment for the primary lesion and were candidates for a pulmonary metastasectomy for complete resection. Among the 20 patients, 13 died: 5 from hepatic failure, 5 from respiratory failure, and 2 from brain metastasis due to recurrence of the HCC. One patient died from cardiac failure without HCC recurrence. At the latest observation, three of the seven survivors were doing well without HCC recurrence, and others survived with recurrence. The overall survival rates after the initial lung surgery were 45.3% at 1 year and 23.8% at 3 years, respectively. The survival rates without recurrence were 32.4% at 1 year and 21.6% at 3 years, respectively. A Kaplan-Meier analysis showed that multiple lung surgeries and a negative histologic finding of the liver cut surface were favorable characteristics for survival without recurrence. In conclusion, the selected patients were Candidates for pulmonary metastasectomy after a curative hepatectomy for HCC and could benefit from the complete resection. Also, repeated pulmonary resections through thoracoscopy could result in the long-term survival of patients with pulmonary recurrence of HCC.

Treatment of tumour recurrence after resection of hepatocellular carcinoma. Analysis of 97 consecutive patients

“…Two of our patients were submitted to a vertebral body resection of a metastasis of HCC in the spine with survival of more than 1 year in one. A few previous reports suggested that resection of an isolated metastasis in the lung, 11,12,14 adrenal gland, 30 peritoneal cavity, 31 and abdominal wall 32 may result in long-term survival in selected patients. A recent study demonstrated that resection of an isolated extrahepatic recurrence might offer long-term survival.…”

Indocyanine Green Fluorescence Navigation Thoracoscopic Metastasectomy for Pulmonary Metastasis of Hepatocellular Carcinoma

“…4) Pulmonary metastasectomy for pulmonary metastasis of HCC has been reported to play an important role in selected patients, particularly in those with a limited number of pulmonary metastases, unilateral metastases, or requiring single pulmonary surgery. [5][6][7] Sorafenib is the first drug that has been shown to be effective for patients with advanced hepatocellular carcinoma. 8) Our patient was administered sorafenib due to the presence of pulmonary metastases and a mediastinal lymph node metastasis.…”

Hepatoma with cardiac metastasis: An advanced cancer requiring advanced treatment

“…In the view of cardiology, the possibility of heart failure and pulmonary embolism increased rapidly when intra-cardiac mass size exceeded 1 cm 3 [2][3][4][5][6] . HCC with cardiac involvement always has malignant presentation and the worst outcome.…”

“…Finally, it is important to note some limitations to the current review. First, data about non-bypass cardiac surgery or simultaneous resection of main tumor and cardiac metastatic tumor, or concurrent resection of pulmonary metastasis [4][5][6] remain unavailable, but these improved surgical techniques may offer better results for advanced HCC patients with cardiac involvement. Second, this study only considers retrospective results, but a prospective study or more data may be necessary to confirm the longterm mortality.…”

“…This group of patients often exhibits symptoms of heart failure owing to flow obstruction or thromboembolism upon diagnosis [1][2][3] . Surgical treatment is generally reserved for symptomatic patients because of poor prognosis [4][5][6] . This study reviews eight cases of hepatoma with heart metastasis in our hospital during 14 years and highlights the importance of early monitoring and surgery for the prognosis of these patients.…”