Oligopulmonary metastases from primary liver tumors are typically treated surgically. We evaluated the clinical outcomes after lung metastasectomy in patients with pulmonary metastases from primary liver tumors. We retrospectively enrolled 147 consecutive patients with lung metastases from liver cancer who had undergone pulmonary metastasectomies at three medical centers between February 2007 and December 2020. All patients were pathologically confirmed to have lung metastases from liver cancer. Among the 147 patients, 110, 17, and 20 initially underwent surgical resection, radiofrequency ablation, and transcatheter arterial embolization, respectively. The 5-year overall survival (OS) in the study cohort was 22%. Univariate analysis revealed four factors associated with better OS: surgical resection as the initial primary liver tumor treatment (p= 0.004), a disease-free interval exceeding 12 months after the initial liver surgery (p= 0.036), a lower Model for End-Stage Liver Disease (MELD)-Na score (≤20) for liver cirrhosis (p= 0.044), and the absence of local liver tumor recurrence at the time of pulmonary metastasectomy (p= 0.004). Multivariate analysis demonstrated that surgical resection as the initial primary liver tumor treatment and lower MELD-Na scores significantly correlated with better OS. Our findings can assist thoracic surgeons in selecting suitable patients for surgery and predicting surgical outcomes.
原发性肝肿瘤的寡肺转移通常采用手术治疗。本研究评估了原发性肝肿瘤肺转移患者接受肺转移瘤切除术后的临床结局。我们回顾性纳入了2007年2月至2020年12月期间在三个医疗中心接受肺转移瘤切除术的147例肝癌肺转移连续病例。所有患者均经病理证实为肝癌肺转移。在147例患者中，分别有110例、17例和20例最初接受了手术切除、射频消融和经导管动脉栓塞治疗。研究队列的5年总生存率为22%。单因素分析显示四个与较好总生存期相关的因素：初始原发性肝肿瘤治疗采用手术切除（p=0.004）、初次肝手术后无病间隔期超过12个月（p=0.036）、肝硬化患者终末期肝病模型（MELD）-Na评分较低（≤20分）（p=0.044），以及肺转移瘤切除术时无局部肝肿瘤复发（p=0.004）。多因素分析表明，初始治疗采用手术切除和较低的MELD-Na评分与较好的总生存期显著相关。本研究结果有助于胸外科医师选择合适的患者进行手术并预测手术结局。
肿瘤(癌症)患者之家