OBJECTIVES: Hepatocellular carcinoma (HCC) is the most common cancer causing death in Taiwan. With the recent advances in diagnostic and surgical techniques, more patients are suitable for hepatectomy. However, the long-term outcome of patients remains poor due to high recurrence rate. Few articles have discussed the benefit of metastasectomy . The aim of this study was to evaluate the role of surgery for pulmonary and other resectable metastases from HCC .
Methods: Eight patients underwent metastasectomy at Chang Gung Memorial Hospital between April 2000 and June 2007 were enrolled in this study. All of them had received the hepatectomy for primary HCC. The demographic information, the site of extrahepatic recurrence, the method of surgical intervention and the outcome were retrospectively reviewed.
Results: There were 6 men and 2 women with the mean age of 48.5 years. Five of them accepted multiple metastasectomy. Six patients had pulmonary metastases removed by wedge resection or lobectomy. One patients accepted craniotomy for metastatic HCC .One patient had the excision of right second rib and right femoral metastasis. One patient had removal of the metastasis from scalp, right atrium and inferior vena cava. The mean survival was 50.7 months (18 to 96 months). Four patients are still alive with or without the disease.
Conclusions: Resection for metastases from HCC resulted in long-term survival in these highly selected patients. Although the number of patients suitable for resection of extrahepatic metastasis after curative hepatectomy for HCC is small, some long-term survivors will benefit. Especially for patients with lung metastases, aggressive surgical resection is recommended if complete resection can be achieved.