Abstract
Hepatitis virus B and C cause not only hepatocellular carcinoma (HCC) but also chronic hepatitis. Chronic hepatitis causes liver damage and often complicates surgery for HCC. Recently, the therapy for hepatitis virus has been improving; therefore, the number of patients who can undergo surgery for HCC may increase and therapy for HCC recurrence will become an issue. This study aimed to investigate the relationship with the prognosis and inflammatory markers such as the neutrophil to lymphocyte ratio and Glasgow prognostic score (known as prognostic factors for primary HCC).
This study retrospectively reviewed 10 patients who underwent pulmonary metastasectomy for HCC metastasis at the University of Yamanashi Hospital between 2001 and 2011.
Nine patients underwent partial pulmonary resection and one patient underwent lobectomy. No patient experienced any complications. Seven patients relapsed and six patients died. There was no local recurrence and 4 of the deaths were cancer-related.
Multivariate analysis revealed a significant difference between NLR>2.31 patients and NLR≤2.31 patients regarding the disease-free survival (hazard ratio: 10.28, P=0.043) and between single metastasis and multiple metastases concerning overall survival (hazard ratio: 2.347, P=0.04) after metastasectomy.
In this study, three of the relapsed patients, who underwent a second surgery for the recurrence, showed a significantly longer overall survival after recurrence than the four other patients (median: 98.6 vs. 12.2 months, respectively; P=0.01).
Although patients with NLR>2.31 have a high risk of recurrence, if the recurrence is limited to the lung or liver, repeated surgery will be useful to prolong the survival.
