Patients
A total of 33 patients who suffered from LLR(n=6) and OLR(n=27) for primary HCC, who developed pulmonary metastasis, as first extrahepatic metastasis, were retrospectively analyzed in our department from January 2014 to August 2020.
The enhanced spiral computed tomography (CT) as the diagnostic criteria of pulmonary metastasis was performed every 1 month during the first 6months and every 3 months thereafter. One case received chemotherapy and one patient received TACE to prevent or postpone postoperative recurrence of HCC. Other patients were reviewed regularly after surgery.
The patients who were pathological diagnosed with HCC accompanied by a history of liver resection were incorporated into the study. We eliminated the patients with the following criteria:(1) the surgical methods were conversion from laparoscopic to laparotomy and hand-assisted laparoscopic surgery;(2) first extrahepatic recurrence was not lung;(3) primary lung tumor;(4) had a history of invasive treatment; (5) incomplete case.
The date was assessed with preoperative factors(including age, sex, underline liver disease, Child-Pugh score, tumor size and number, portal vein thrombus),intraoperative factors(duration and number of portal vine occlusion, operation time),postoperative therapy(including chemotherapy, targeted therapy, radiofrequency ablation, TACE) ,laboratory inspection before PM(AFP, CA-199, neutrophil count, lymphocyte count, monocyte count, eosinophils count, basophil count),time of pulmonary metastasis and survival time and overall survival rate. The tumor size was defined as the maximum diameter of a single or the sum of maximum diameter of multiple tumors. We defined the time from the date of LLR or OLR to the date of death or last follow-up as survival time. The time of PM was the time from the date of LLR or OLR to the date of diagnosis of PM from HCC by CT.