Recurrence after pulmonary metastasectomy (PM) is frequent, but it is unclear to whom repeated pulmonary metastasectomy (RPM) offers highest benefits. Retrospective analysis of oncological and post-operative outcomes of consecutive patients who underwent PM from 2003 to 2018. Overall survival (OS) and disease-free interval (DFI) were calculated. Cox regression was used to identify variables influencing OS and DFI. In total, 264 patients (female/male: 114/150; median age: 62 years) underwent PM for colorectal cancer (32%), sarcoma (19%), melanoma (16%) and other primary tumors (33%). Pulmonary metastasectomy was approached by video-assisted thoracic surgery (VATS) in 73% and pulmonary resection was realized by non-anatomical resection in 76% of cases. The overall median follow-up time was 33 months (IQR 16-56 months) and overall 5-year survival rate was 62%. Local or distant recurrences were observed in 172 patients (65%) and RPM could be performed in 66 patients (25%) for a total of 116 procedures. RPM was realized by VATS in 49% and pulmonary resection by wedge in 77% of cases. In RPM patients, the 5-year survival rate after first PM was 79%. Post-operative cardio-pulmonary complication rate (13% vs. 12%; p = 0.8) and median length of stay (4 vs. 5 days; p = 0.2) were not statistically different between first PM and RPM. Colorectal cancer (HR 0.56), metachronous metastasis (HR 0.48) and RPM (HR 0.5) were associated with better survival. In conclusion, our results suggest that RPM offers favorable survival rates without increasing post-operative morbidity.
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http://dx.doi.org/10.1007/s10585-020-10056-w | DOI Listing |
Pediatr Surg Int
December 2024
University of Joinville's Region, Joinville, Brazil.
This meta-analysis aimed to compare the outcomes of video-assisted thoracic surgery (VATS) and open thoracotomy in pediatric patients undergoing pulmonary metastasectomy for various malignancies. We systematically searched PubMed, Embase, and Cochrane Library databases for studies comparing VATS and open thoracotomy in pediatric patients. The treatment effects for continuous outcomes were compared using mean differences (MDs), and binary endpoints were evaluated using odds ratios (ORs), with 95% confidence intervals (CIs).
View Article and Find Full Text PDFJ Clin Med
November 2024
Division of Thoracic Surgery, Candiolo Cancer Institute, FPO-IRCCS, 10060 Candiolo, Italy.
We would like to express our sincere gratitude for the thoughtful reflections on our recent study regarding pulmonary metastasectomy, and we greatly appreciate the constructive dialog that our work has sparked [...
View Article and Find Full Text PDFJ Clin Med
November 2024
Centre for Trials Research, Cardiff University, Cardiff CF10 3AT, UK.
We were interested to read the results from the Italian database [...
View Article and Find Full Text PDFClin Exp Metastasis
December 2024
Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Recent studies report excellent local control (LC) and favorable toxicities of stereotactic ablative radiotherapy (SABR) for pulmonary metastasis (PM) from sarcoma. This study compared the LC and survival of SABR and metastasectomy for sarcoma PM. We analyzed the LC rates of 54 PMs treated with SABR between 2008 and 2022.
View Article and Find Full Text PDFJ Surg Oncol
December 2024
Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Background And Objectives: Due to heterogeneous characteristics of primary cancers, the efficacy of pulmonary metastasectomy (PM) in nonprimary lung cancers has not been investigated. This study aims to investigate the clinical outcomes of PM for non-primary lung cancer.
Methods: A systematic search for meta-analyses on PM for nonprimary lung cancers was conducted, encompassing publications up to January 3, 2024.
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