Significance and Indication of Surgery for Pulmonary Metastasis after Hepatic Resection for Hepatocellular Carcinoma

Yoshihiro Nishino, Kazuhiro Hirohashi, Taichi Shuto, Kiyotoshi Inoue, Kunihiro Katsuragi, Hiromu Tanaka, Shoji Kubo and Hiroaki Kinoshita

Second Department of Surgery, Osaka City University Medical School

Between 1981 and 1998, 562 patients with hepatocellular carcinoma (HCC) underwent hepatic resection, and during the same period, 23 of these patients were detected to have pulmonary metastases. These 23 patients with pulmonary metastases were divided into two groups according to the mode of treatment of the pulmonary metastases; the pulmonary resection group (PR group: n=8) and the non-pulmonary resection group (non-PR group: n=15). The clinicopathological profile of both the groups as analyzed to elucidate the usefulness of surgical treatment for these patients. At the time of the first hepatic resection, there was no significant difference in the clinicopathological profile between the two groups. The pulmonary metastases were countable in all the patients of the PR group, while they were uncountable in 3 patients of the non-PR group. The existence of hepatic recurrence at the time of diagnosis of the pulmonary metastases bad no bearing on the prognosis. The survival rate after the first hepatic resection in the PR group was significantly higher than that in the non-PR group (p<0. 05). It can be concluded that resection of the pulmonary metastases in patients with countable pulmonary lesions resulted in a favorable outcome with no deaths due to respiratory failure. Consequently, pulmonary resection, if possible, should be the treatment method of choice in these patients.

Key words
hepatocellular carcinoma, pulmonary metastasis of hepatocellular carcinoma, metastatic lung cancer, pulmonary resection

Reprint requests
Yoshihiro Nishino Second Department of Surgery, Osaka City University Medical School 1-4-3 Asahi-machi, Abeno-ku, Osaka City, 545-8585 JAPAN

Accepted
April 26, 2000

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