Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 21, 2009; 15(43): 5481-5488
Published online Nov 21, 2009. doi: 10.3748/wjg.15.5481
Efficacy of surgical resection in management of isolated extrahepatic metastases of hepatocellular carcinoma
Kun-Ming Chan, Ming-Chin Yu, Ting-Jung Wu, Chen-Fang Lee, Tse-Ching Chen, Wei-Chen Lee, Miin-Fu Chen
Kun-Ming Chan, Ming-Chin Yu, Ting-Jung Wu, Chen-Fang Lee, Wei-Chen Lee, Miin-Fu Chen, Department of General Surgery, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, 33305 Taoyuan, Taiwan, China
Tse-Ching Chen, Department of Pathology, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, 33305 Taoyuan, Taiwan, China
Author contributions: Chan KM performed the research, analyzed the data, and wrote the paper; Yu MC, Wu TJ, Lee CF and Chen TC collected the data; Lee WC and Chen MF designed the research.
Correspondence to: Wei-Chen Lee, MD, Department of General Surgery, Chang Gung Memorial Hospital-Linkou Medical Center, Chang Gung University College of Medicine, 5, Fu-Hsing Street, Kwei-Shan Township, Taoyuan County, 33305, Taiwan, China. weichen@cgmh.org.tw
Telephone: +886-3-3281200 Fax: +886-3-3285818
Received: July 25, 2009
Revised: October 12, 2009
Accepted: October 19, 2009
Published online: November 21, 2009
Abstract

AIM: To clarify the benefit of surgical excision for patients with extrahepatic metastases of hepatocellular carcinoma (HCC).

METHODS: We retrospectively reviewed the medical records of 140 patients with pathologically proven extrahepatic metastases of HCC and evaluated the outcomes of those who had undergone surgical resection (SR) for extrahepatic metastatic lesions. Prognoses made on the basis of extrahepatic metastatic sites were also examined.

RESULTS: The survival rates of patients who underwent SR of extrahepatic metastases were significantly better than those of patients who did not receive SR. For the SR group, 1- and 3-year survival rates were 24% and 7%, respectively, while for the non-resection group, the survival rates were 8% and 0%, respectively (P < 0.0001). Survival rates related to metastatic sites were also significantly superior after SR of extrahepatic metastases: median survivals were 32 mo with lung metastasis, 10 mo with bone metastasis, 6.1 mo with brain metastasis.

CONCLUSION: SR can provide survival benefits for patients with 1 or 2 isolated extrahepatic metastases and who concurrently exhibit good hepatic functional reserve and general performance status as well as successful treatment of intrahepatic HCC.

Keywords: Hepatocellular carcinoma; Hepatic resection; Extrahepatic metastases; Surgical resection; Outcome