The effect of Transarterial Chemoembolization(TAE) on Lung metastasis of Hepatocellular Carcinoma

Abstract

Background: During the follow up period after transarterial embolization(TAE), cases of pulmonary metastasis were more prevalent in TAE-treated patients than in TAE-untreated patients. Therefore, a study was conducted to evaluate whether TAE increases the incidence of pulmonary metastasis of hepatocellular carcinoma and to clarify the risk factors for pulmonary metastasis. Methods: From March 1991 to March 1995, 156 patients who had been diagnosed with hepatocellular carcinoma by serology, and radiographic and histologic methods at Yeungnam University hospital were involved in this study. We excluded 12 patients with lung metastasis on initial diagnosis and the others. The remaining 144 patients had been followed up for at least 5 months and, divided into four groups according to lung metastasis and trans-arterial embolization treatment, and evaluated for age, sex, child-pugh score, liver cirrhosis, and level of AFP. Results: Pulmonary metastasis was found in 18.0% (26/144), of which 92.3%(24/26) and 7.7%(2/26) of the patients with and without transarterial chemoembolization, respectively. Of the patients, 23.5% (24/102) with TAE had lung metastais during follow-up periods and 4.7% (2/42) without TAE had lung metastasis. There was more likelihood for lung metastasis after TAE. but there was no difference between two groups in age, sex, child-pugh class, the presence of liver cirrhosis, and AFP. Conclusions: The incidence of pulmonary metastasis of hepatocellular carcinoma after TAE was higher. Child-pugh class was the only related clinical preciptating factors for pulmonary metastasis in TAE in our study. Our results suggest that regular chest X-ray check-ups may be more frequently needed by patients who had TAE treatment for hepatocellular carcinoma.