Ablation of Pulmonary Oligometastasis Combined With System for Advanced Hepatocellular Carcinoma

Inclusion criteria

• diagnosis of primary HCC, confirmed histologically or clinically according to the criteria of the American Association for the Study of Liver Diseases;
• presence of pulmonary oligometastasis, the metastases found within three month of HCC diagnosis;
• metastases with limited five sites and no more two organs involved, with a maximum diameter of ≤5cm;
• receipt of first-line systemic therapy for minimum of 3 months before ablation, with controlled intrahepatic tumors and no progression of metastases. Controlled intrahepatic tumors were defined as those showing a partial or stable response according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST);
• undergone locoregional treatments, including transarterial artery chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC) were included;
• classified as Child-Pugh class A or B and having an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
• no history of other malignancies.
• life expectancy more than 3 months;
• agreed to participated in this clinical trial;
• Hemameba ≥3.0 x109/L, neutrophil ≥1.5x109/L, hemoglobin≥10.0 g/L, platelet≥100x 109/L, ALT; AST; bilirubin ≤1.5-fold normal, GFR≥60ml/min.

Exclusion criteria

• intermediate HCC;
• age \< 18 years or \> 75 years;
• advanced HCC with more than five metastases;
• no response to Lenvatinib;
• metastases size \> 5 cm;
• life expectancy less than 3 months.