Prognostic efficacy of treatment for extrahepatic metastasis after surgical treatment of hepatocellular carcinoma.

The purpose of the present study was to investigate, retrospectively, the clinical significance of treatments for extrahepatic metastasis after surgical treatment of hepatocellular carcinoma (HCC). Forty-seven patients, in whom extrahepatic metastasis developed after hepatic resection or microwave coagulation therapy (MCT) for primary HCC, were enrolled in this study. Metastatic organs were lung (38 cases), bone (10 cases), brain (6 cases), adrenal gland (3 cases), and lymph nodes (9 cases), including duplicated cases. Twenty eight patients were treated with surgical resection, anticancer chemotherapy, radiation and immunotherapy for the extrahepatic metastasis (the treatment group). Nineteen patients were in no treatment except symptomatic therapy (the non-treatment group). The 1- and 3-year survival rates after development of extrahepatic metastasis in the treatment group were 42.3% and 17.8%, respectively. No patients in the non-treatment group survived more than 2 years. There was a significant difference between the treatment and the non-treatment group (p = 0.0021) with regard to survival rate. Univariate analysis of the treatment group showed the following factors to be significant for survival: 1) intrahepatic lesion(s) was cleared or well controlled by some type of treatment, 2) the treatment for extrahepatic metastasis was effective, 3) extrahepatic metastasis was recognized in Grade A of Child-Pugh classification. Treatment of extrahepatic metastasis of HCC was of great significance for the prognosis.