Long-Term Survival and Prognostic Factors of Pulmonary Metastasectomy in Liver Cancer: A Systematic Review and Meta-Analysis

Background Lung is the most common extrahepatic metastatic organ of liver cancer. Surgical resection is a common local treatment for pulmonary metastasis. But the long-term prognosis of pulmonary metastasectomy varies greatly due to the small sample size and different results of previous studies. Th...

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Bibliographic Details
Published in:World journal of surgery 2018-07, Vol.42 (7), p.2153-2163
Main Authors: Wang, Chong, Yang, Lei, Liang, Zikun, Liu, Yaodong, Liu, Shuku
Format: Article
Language:English
Subjects:
Abdominal Surgery
Cancer
Cardiac Surgery
Cirrhosis
Confidence intervals
Disease-Free Survival
General Surgery
Humans
Liver
Liver cancer
Liver cirrhosis
Liver Cirrhosis - complications
Liver Neoplasms - complications
Liver Neoplasms - pathology
Lung cancer
Lung Neoplasms - complications
Lung Neoplasms - secondary
Lung Neoplasms - surgery
Medical prognosis
Medicine
Medicine & Public Health
Meta-analysis
Metastasectomy
Metastases
Metastasis
Patients
Pneumonectomy
Prognosis
Quality assessment
Quality control
Risk Factors
Scientific Review
Studies
Surgery
Survival
Survival Rate
Systematic review
Thoracic Surgery
Vascular Surgery
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Summary:Background Lung is the most common extrahepatic metastatic organ of liver cancer. Surgical resection is a common local treatment for pulmonary metastasis. But the long-term prognosis of pulmonary metastasectomy varies greatly due to the small sample size and different results of previous studies. Therefore, we conducted this meta-analysis to evaluate the combined 5-year overall survival (OS) rate and prognostic factors after pulmonary metastasectomy in liver cancer. Methods Key words such as liver cancer pulmonary metastasis and metastasectomy were retrieved firstly in PubMed, Cochrane Library, Embase and Chinese Wanfang databases. Eligible studies were identified by manual searches. Each included study should report 5-year OS rate and/or prognostic factors of pulmonary metastasectomy. Newcastle–Ottawa Scale was used for quality assessment, and heterogeneity was estimated by I 2 . We calculated the combined 5-year survival rates and determined the prognostic factors for OS by the hazard ratios (HR) and number of events. Results Seventeen cohort studies with a total of 513 patients were included in this meta-analysis. The combined 5-year survival rates after pulmonary metastasectomy were 33% [95% confidence interval (95% CI) 29–37%]. The poor prognostic factors were disease-free interval (DFI) 
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-017-4431-7