Surgical resection for pulmonary metastasis from hepatocellular carcinoma: Analysis of prognosis in relation to primary control

Background: Advances in local treatments for hepatocellular carcinoma (HCC) have seen better prognosis. There were few studies on surgery for pulmonary metastasis from HCC controlled by local treatment. This study was conducted to analyze prognostic factors after surgery for pulmonary metastasis from HCC. Methods: We reviewed 32 patients who underwent surgery for pulmonary metastasis from HCC and analyzed prognostic factors. Results: HCC was controlled by surgery in 16 patients and by local treatment in 16 patients at the time of pulmonary resection. The median survival time after pulmonary resection was significantly better for HCC controlled by surgery, disease-free time ≥12 months, TMN stage I-II, and T factor 1-2 of primary HCC. The median survival time was better for lesion ≤2 and Child-Pugh score A, but they were not significant (P=0.053, 0.069). In multivariate analysis, HCC controlled by surgical treatment (P=0.008), and lesion ≤2 (P=0.030) were independent prognostic factors. Conclusion: Our Results indicated that surgical resection for pulmonary metastasis from HCC might be beneficial for patients whose HCC was controlled by surgery and the number of lesions was lower than 3.