Transcatheter arterial embolization treatment in patients with hepatocellular carcinoma and risk of pulmonary metastasis

AIM: To investigate the relationship between transcatheterarterial embolization (TAE) and pulmonary metastasis insubjects with hepatocellular carcinoma (HCC). METHODS: A total of 287 patients with HCC followed upfor more than 1 week were included. 102 patients underwenttranscatheter arterial embolization (TAE group) and 185received conservative treatment(control group). Thepatients' chest x-rays and chest CT scans were examinedfor pulmonary metastasis.RESULTS: Patients with TAE had a median survival of 19.3months while that of the control group was only 10.0 months(P＜0.05). Pulmonary metastasis occurred in 14 (13.7 %)patients in the TAE group and 14 (7.6 %) patients in the control group, there was no significant difference (P＞0.05).The 1-year, 2-year and 5-year cumulative incidence of pulmonary metastasis was 11.8 %, 17.6 % and 24.0 % in the TAE group and 7.0 %, 13.0 % and 21.7 % in the control group, respectively (P＞0.05). On the univariate analysis,tumor size, abnormal serum alanine aminotransferase levels and heterogeneity on sonography were significantly associated with pulmonary metastasis. However, on the multivariate analysis, only tumor size was significantly predictive of pulmonary metastasis.CONCLUSION: TAE is effective on prolonging survival of patients with HCC. It does not significantly increase the risk of pulmonary metastasis. Tumor size is the only significant predictive factor associated with lung metastasis.