|Table of Contents|

Postoperative adjuvant TACE can prevent the early occurrence of lung metastasis in hepatocellular carcinoma patients

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2017 02
Page:
241-245
Research Field:
Publishing date:

Info

Title:
Postoperative adjuvant TACE can prevent the early occurrence of lung metastasis in hepatocellular carcinoma patients
Author(s):
Yang Yongbo1; Jiang Lai2; Ding Guojun1; Sun Song1; Shao Guoliang1
1.Department of Radiology；2.Department of Oncological Surgery,Zhejiang Cancer Hospital，Zhejiang Hangzhou 310004，China.
Keywords:
hepatocellular carcinoma; lung metastasis; surgery; chemoembolization; therapeutic; risk
PACS:
R735.7
DOI:
10.3969/j.issn.1672-4992.2017.02.021
Abstract:
Objective:To investigate the risk factors for the early occurrence of lung metastasis after surgery in HCC patients.Methods：A total of 284 patients that were diagnosed with hepatocellular carcinoma in the postoperative pathology and detected lung metastasis during the follow-up were analyzed respectively.Calculate the cumulative incidence of lung metastasis for different risk factors by the Kaplan-Meier method.21 possible risk factors were entered into the COX regression model for univariate analysis and followed by multivariate analysis,including preoperative laboratory tests,imaging findings,and postoperative pathology,then compared the difference of the time to lung metastasis between patients with or without adjuvant TACE by the Log-Rank test.Results:Maximum diameter of tumor≥10cm,multifocal lesions and merging tumor thrombosis in preoperative imaging findings,and incomplete or absent tumor capsular,larger necrosis and merging satellite lesions in postoperative pathology were significant high risk factors for lung metastasis in patients with HCC after surgery by COX univariate and multivariate analysis.The median time to lung metastasis in high-risk patients with adjuvant TACE treatment after surgery was significantly longer than those without adjuvant TACE (P=0.010),while there was no significant difference between those patients.Conclusion:Lung metastasis tended to occur significantly earlier in patients with tumor maximum diameter≥10cm,multifocal lesions and merging tumor thrombosis in preoperative imaging findings,and incomplete or absent tumor capsular,larger necrosis and merging satellite lesions in postoperative pathology.Postoperative adjuvant TACE can prevent the early occurrence of lung metastasis in high-risk patients that indicated by preoperative imaging and postoperative pathology.

References:

［1］Lopez PM,Villanueva A,Llovet JM.Systematic review:Evidence-based management of hepatocellular carcinoma-an updated analysis of randomized controlled trials［J］.Aliment Pharmacol Ther,2006,23(11):1535-1547.
[2]Berger Y,Spivack JH,Heskel M,et al.Extrahepatic metastasectomy for hepatocellular carcinoma:Predictors of long-term survival［J］.J Surg Oncol,2016,114(4):469-474.
[3]Lam CM,Lo CM,Yuen WK,et al.Prolonged survival in selected patients following surgical resection for pulmonary metastasis from hepatocellular carcinoma［J］.Br J Surg,1998,85(9):1198-1200.
[4]Yoo JJ,Lee JH,Lee SH,et al.Comparison of the effects of transarterial chemoembolization for advanced hepatocellular carcinoma between patients with and without extrahepatic metastases［J］.PLoS One,2014,9(11):e113926.
[5]Lee JI,Kim JK,Kim do Y,et al.Prognosis of hepatocellular carcinoma patients with extrahepatic metastasis and the controllability of intrahepatic lesions［J］.Clin Exp Metastasis,2014,31(4):475-482.
[6]Uchino K,Tateishi R,Shiina S,et al.Hepatocellular carcinoma with extrahepatic metastasis:Clinical features and prognostic factors［J］.Cancer,2011,117(19):4475-4483.
[7]Zhang SM,Zeng SC,Sun J,et al.Analysis of prognostic factors of lung metastases of hepatocellular carcinoma［J］.J Practical Oncol,2005，20(5):395-400.［张树民,曾昭冲,孙菁,等.肝细胞肝癌肺转移的预后因素分析［J］.实用肿瘤杂志,2005,20(5):395-400.］
[8]Katyal S,Oliver JH,Peterson MS,et al.Extrahepatic metastases of hepatocellular carcinoma［J］.Radiology,2000,216(3):698-703.
[9]Brown JJ,Naylor MJ,Yagan N.Imaging of hepatic cirrhosis［J］.Radiology,1997,202(1):1-16.
[10]Ministry of Health of the People's Republic of China.Diagnosis,management,and treatment of hepatocellular carcinoma (V2011)［J］.Chin Clin Oncol,2011,16(10):929-946.［中华人民共和国卫生部.原发性肝癌诊疗规范(2011年版)［J］.临床肿瘤学杂志,2011,16(10):929-946.］
[11]Goh BK,Teo JY,Chan CY,et al.Importance of tumor size as a prognostic factor after partial liver resection for solitary hepatocellular carcinoma:Implications on the current AJCC staging system［J］.J Surg Oncol,2016,113(1):89-93.
[12]Forner A,Reig ME,de Lope CR,et al.Current strategy for staging and treatment:The BCLC update and future prospects［J］.Semin Liver Dis,2010,30(1):61-74.
[13]Wu CC,Ho YZ,Ho WL,et al.Preoperative transcatheter arterial chemoembolization for resectable large hepatocellular carcinoma:A reappraisal［J］.Br J Surg,1995,82(1):122-126.
[14]Chou CT,Chen RC,Lin WC,et al.Prediction of microvascular invasion of hepatocellular carcinoma:Preoperative CT and histopathologic correlation［J］.AJR Am J Roentgenol,2014,203(3):W253-259.
[15]Ishizaki M,Ashida K,Higashi T,et al.The formation of capsule and septum in human hepatocellular carcinoma［J］.Virchows Arch,2001,438(6):574-580.
[16]Wu F,Wang LM,Wu JX,et al.Analysis of risk factors of recurrence in patients with BCLC 0-A hepatocellular carcinoma after surgical resection［J］.National Madical J China,2015,95(22):1747-1750.［吴凡,王黎明,吴健雄,等.巴塞罗那分期0-A期肝细胞肝癌术后复发危险因素分析［J］.中华医学杂志,2015,95(22):1747-1750.］
[17]Tanaka T,Yamanaka N,Oriyama T,et al.Factors regulating tumor pressure in hepatocellular carcinoma and implications for tumor spread［J］.Hepatology,1997,26(2):283-287.
[18]Seong J,Park HC,Han KH,et al.Local radiotherapy for unresectable hepatocellular carcinoma patients who failed with transcatheter arterial chemoembolization［J］.Int J Radiat Oncol Biol Phys,2000,47(5):1331-1335.
[19]Iguchi T,Aishima S,Sanefuji K,et al.Both fibrous capsule formation and extracapsular penetration are powerful predictors of poor survival in human hepatocellular carcinoma:A histological assessment of 365 patients in Japan［J］.Ann Surg Oncol,2009,16(9):2539-2546.
[20]Peng BG,He Q,Li JP,et al.Adjuvant transcatheter arterial chemoembolization improves efficacy of hepatectomy for patients with hepatocellular carcinoma and portal vein tumor thrombus［J］.Am J Surg,2009,198(3):313-318.
[21]Xiao JC,Zhang HK,Zhang JW,et al.Combined transarterial chemoembolization and bronchial artery infusion to prevent lung metastases from liver cancer with hepatic artery hepatic veaous fistula［J］.Modern Oncology,2007,15(1):53-54.［肖金成,张宏凯,张建伟,等.支气管动脉化疗灌注对存在肝动静脉瘘的肝癌肺转移的预防［J］.现代肿瘤医学,2007,15(1):53-54.］
[22]Llovet JM,Ricci S,Mazzaferro V,et al.Sorafenib in advanced hepatocellular carcinoma［J］.N Engl J Med,2008,359(4):378-390.
[23]Pinter M,Sieghart W,Graziadei I,et al.Sorafenib in unresectable hepatocellular carcinoma from mild to advanced stage liver cirrhosis［J］.Oncologist,2009,14(1):70-76.
[24]Feng YX,Wang T,Deng YZ,et al.Sorafenib suppresses postsurgical recurrence and metastasis of hepatocellular carcinoma in an orthotopic mouse model［J］.Hepatology,2011,53(2):483-492.

Memo

Memo:
浙江省医药卫生科技项目（编号：2014KYB041）
Last Update: 2016-12-01