原发性肝癌肺转移患者行肺转移灶切除的疗效探讨

Efficacy of Pulmonary Resection for Primary Hepatocellular Carcinoma Patients with Pulmonary Metastasis

背景与目的:肺转移灶切除被认为是发生肺转移的恶性肿瘤患者的一种积极的治疗方法。本文探讨原发性肝癌(下称肝癌)肺转移患者行转移灶切除的疗效。方法:回顾性分析12例肝癌肺转移行转移灶切除患者的临床病理资料及疗效。结果:12例患者中,9例肺转移灶数目为1～2个,其中1例在首次肺转移灶切除后再次出现肺转移。3例肺转移灶数目为3个或3个以上,在首次肺转移灶切除后均再次出现肺转移。全组患者首次肝切除后中位生存时间为52个月,首次肺切除后中位生存时间为24个月。全组患者首次肝切除后1、3、5年总体生存率分别为100.0%、75.0%、47.3%,首次肺切除后1、3、5年生存率分别为83.3%、46.7%、21.0%。结论:在肝内复发肝癌病灶能够得到有效控制的前提下,肺转移灶数目为1个或2个的患者可从肺转移灶切除中获益,并有可能获得长期生存。

BACKGROUND ＆ OBJECTIVE： Pulmonary resection is considered as an active therapy for malignant tumor patients with pulmonary metastasis. This study was to evaluate the efficacy of pulmonary resection for primary hepatocellular carcinoma （HCC） patients with pulmonary metastasis. METHODS： Clinicpathologic data and outcomes of 12 HCC patients underwent pulmonary resection due to pulmonary metastasis were analyzed. RESULTS： Among the 12 patients, 9 had 1 or 2 pulmonary metastases, 1 of which had relapsed pulmonary metastasis after the first pulmonary resection; the other 3 patients who had 3 or more pulmonary metastases all recurred with pulmonary metastasis after the first pulmonary resection. The median survival time was 52 months after the first hepatectomy and 24 months after the first pulmonary resection. The overall 1-, 3- and 5-year survival rates were 100.0% ,75.0% and 47.3% after the first hepatectomy, and 83.3%, 46.7% and 21.0% after the first pulmonary resection, respectively, CONCLUSION： When intrahepatic recurrence is effectively controlled, HCC patients with 1 or 2 pulmonary metastases might benefit from pulmonary resection and achieve prolonged survival.