Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence

Francesco Londero, Angelo Morelli, Orlando Parise, William Grossi, Sara Crestale, Cecilia Tetta, Daniel M Johnson, Ugolino Livi, Jos G Maessen, Sandro Gelsomino

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND OBJECTIVES: Lymphadenectomy during pulmonary metastasectomy (PM) is widely carried out. We assessed the potential benefit on patient survival and tumor recurrence of this practice.

METHODS: One hundred eighty-one patients undergoing a first PM were studied. Eighty-six patients (47.5%) underwent lymphadenectomy (L+ group) whereas 95 (52.5%) did not undergo nodal harvesting (L-group). Main outcomes were overall survival (OS) and disease-free survival (DFS). Median follow-up was 25 months (interquartile range [IQR], 13-49).

RESULTS: At follow-up 84 patients (46.4%) died, whereas 97 (53.6%) were still alive with recurrence in 78 patients (43%). There was no difference in 5-year survival (L+ 30.0% vs L- 43.2%; P = .87) or in the 5-year cumulative incidence of recurrence (L + 63.2% vs L-80%; P = .07) between the two groups. Multivariable analysis indicated that disease-free interval (DFI) less than 29 months (P < .001) and lung comorbidities (P = .003) were significant predictors of death. Metastases from non-small-cell lung cancer increased the risk of lung comorbidities by a factor of 19.8, whereas the risk of DFI less than 29 months was increased nearly 11-fold. Competing risk regression identified multiple metastases (P = .004), head/neck primary tumor (P = .009), and age less than 67 years (P = .024) as independent risk factors for recurrence.

CONCLUSION: Associated lymphadenectomy showed not to give any additional advantage in terms of survival and recurrence after PM.

Original languageEnglish
Pages (from-to)768-778
Number of pages11
JournalJournal of Surgical Oncology
Volume120
Issue number4
DOIs
Publication statusPublished - Sep 2019

Fingerprint

Metastasectomy
Lymph Node Excision
Recurrence
Lung
Survival
Comorbidity
Neoplasm Metastasis
Non-Small Cell Lung Carcinoma
Disease-Free Survival
Neoplasms
Neck
Head
Incidence

Keywords

  • lung metastases
  • lung resections
  • lymphadenectomy

Cite this

Londero, F., Morelli, A., Parise, O., Grossi, W., Crestale, S., Tetta, C., ... Gelsomino, S. (2019). Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence. Journal of Surgical Oncology, 120(4), 768-778. https://doi.org/10.1002/jso.25635

Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence. / Londero, Francesco; Morelli, Angelo; Parise, Orlando; Grossi, William; Crestale, Sara; Tetta, Cecilia; Johnson, Daniel M; Livi, Ugolino; Maessen, Jos G; Gelsomino, Sandro.

In: Journal of Surgical Oncology, Vol. 120, No. 4, 09.2019, p. 768-778.

Research output: Contribution to journalArticle

Londero, F, Morelli, A, Parise, O, Grossi, W, Crestale, S, Tetta, C, Johnson, DM, Livi, U, Maessen, JG & Gelsomino, S 2019, 'Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence', Journal of Surgical Oncology, vol. 120, no. 4, pp. 768-778. https://doi.org/10.1002/jso.25635
Londero F, Morelli A, Parise O, Grossi W, Crestale S, Tetta C et al. Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence. Journal of Surgical Oncology. 2019 Sep;120(4):768-778. https://doi.org/10.1002/jso.25635
Londero, Francesco ; Morelli, Angelo ; Parise, Orlando ; Grossi, William ; Crestale, Sara ; Tetta, Cecilia ; Johnson, Daniel M ; Livi, Ugolino ; Maessen, Jos G ; Gelsomino, Sandro. / Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence. In: Journal of Surgical Oncology. 2019 ; Vol. 120, No. 4. pp. 768-778.
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abstract = "BACKGROUND AND OBJECTIVES: Lymphadenectomy during pulmonary metastasectomy (PM) is widely carried out. We assessed the potential benefit on patient survival and tumor recurrence of this practice.METHODS: One hundred eighty-one patients undergoing a first PM were studied. Eighty-six patients (47.5{\%}) underwent lymphadenectomy (L+ group) whereas 95 (52.5{\%}) did not undergo nodal harvesting (L-group). Main outcomes were overall survival (OS) and disease-free survival (DFS). Median follow-up was 25 months (interquartile range [IQR], 13-49).RESULTS: At follow-up 84 patients (46.4{\%}) died, whereas 97 (53.6{\%}) were still alive with recurrence in 78 patients (43{\%}). There was no difference in 5-year survival (L+ 30.0{\%} vs L- 43.2{\%}; P = .87) or in the 5-year cumulative incidence of recurrence (L + 63.2{\%} vs L-80{\%}; P = .07) between the two groups. Multivariable analysis indicated that disease-free interval (DFI) less than 29 months (P < .001) and lung comorbidities (P = .003) were significant predictors of death. Metastases from non-small-cell lung cancer increased the risk of lung comorbidities by a factor of 19.8, whereas the risk of DFI less than 29 months was increased nearly 11-fold. Competing risk regression identified multiple metastases (P = .004), head/neck primary tumor (P = .009), and age less than 67 years (P = .024) as independent risk factors for recurrence.CONCLUSION: Associated lymphadenectomy showed not to give any additional advantage in terms of survival and recurrence after PM.",
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T1 - Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence

AU - Londero, Francesco

AU - Morelli, Angelo

AU - Parise, Orlando

AU - Grossi, William

AU - Crestale, Sara

AU - Tetta, Cecilia

AU - Johnson, Daniel M

AU - Livi, Ugolino

AU - Maessen, Jos G

AU - Gelsomino, Sandro

N1 - © 2019 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.

PY - 2019/9

Y1 - 2019/9

N2 - BACKGROUND AND OBJECTIVES: Lymphadenectomy during pulmonary metastasectomy (PM) is widely carried out. We assessed the potential benefit on patient survival and tumor recurrence of this practice.METHODS: One hundred eighty-one patients undergoing a first PM were studied. Eighty-six patients (47.5%) underwent lymphadenectomy (L+ group) whereas 95 (52.5%) did not undergo nodal harvesting (L-group). Main outcomes were overall survival (OS) and disease-free survival (DFS). Median follow-up was 25 months (interquartile range [IQR], 13-49).RESULTS: At follow-up 84 patients (46.4%) died, whereas 97 (53.6%) were still alive with recurrence in 78 patients (43%). There was no difference in 5-year survival (L+ 30.0% vs L- 43.2%; P = .87) or in the 5-year cumulative incidence of recurrence (L + 63.2% vs L-80%; P = .07) between the two groups. Multivariable analysis indicated that disease-free interval (DFI) less than 29 months (P < .001) and lung comorbidities (P = .003) were significant predictors of death. Metastases from non-small-cell lung cancer increased the risk of lung comorbidities by a factor of 19.8, whereas the risk of DFI less than 29 months was increased nearly 11-fold. Competing risk regression identified multiple metastases (P = .004), head/neck primary tumor (P = .009), and age less than 67 years (P = .024) as independent risk factors for recurrence.CONCLUSION: Associated lymphadenectomy showed not to give any additional advantage in terms of survival and recurrence after PM.

AB - BACKGROUND AND OBJECTIVES: Lymphadenectomy during pulmonary metastasectomy (PM) is widely carried out. We assessed the potential benefit on patient survival and tumor recurrence of this practice.METHODS: One hundred eighty-one patients undergoing a first PM were studied. Eighty-six patients (47.5%) underwent lymphadenectomy (L+ group) whereas 95 (52.5%) did not undergo nodal harvesting (L-group). Main outcomes were overall survival (OS) and disease-free survival (DFS). Median follow-up was 25 months (interquartile range [IQR], 13-49).RESULTS: At follow-up 84 patients (46.4%) died, whereas 97 (53.6%) were still alive with recurrence in 78 patients (43%). There was no difference in 5-year survival (L+ 30.0% vs L- 43.2%; P = .87) or in the 5-year cumulative incidence of recurrence (L + 63.2% vs L-80%; P = .07) between the two groups. Multivariable analysis indicated that disease-free interval (DFI) less than 29 months (P < .001) and lung comorbidities (P = .003) were significant predictors of death. Metastases from non-small-cell lung cancer increased the risk of lung comorbidities by a factor of 19.8, whereas the risk of DFI less than 29 months was increased nearly 11-fold. Competing risk regression identified multiple metastases (P = .004), head/neck primary tumor (P = .009), and age less than 67 years (P = .024) as independent risk factors for recurrence.CONCLUSION: Associated lymphadenectomy showed not to give any additional advantage in terms of survival and recurrence after PM.

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KW - lung resections

KW - lymphadenectomy

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JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

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