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 language | English |
|---|---|
| Pages (from-to) | 768-778 |
| Number of pages | 11 |
| Journal | Journal of Surgical Oncology |
| Volume | 120 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Sep 2019 |
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Keywords
- lung metastases
- lung resections
- lymphadenectomy
Cite this
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 journal › Article
}
TY - JOUR
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.
KW - lung metastases
KW - lung resections
KW - lymphadenectomy
U2 - 10.1002/jso.25635
DO - 10.1002/jso.25635
M3 - Article
C2 - 31297837
VL - 120
SP - 768
EP - 778
JO - Journal of Surgical Oncology
JF - Journal of Surgical Oncology
SN - 0022-4790
IS - 4
ER -