Abstract
Objective: The impact of lymph node involvement in lung metastasectomy from extrapulmonary malignancies is uncertain. We assessed the prognostic value of lymph node status in lung metastasectomy and the prevalence of unexpected mediastinal lymph node involvement after lymph node sampling or dissection. Methods: From May 1998 to October 2005, 388 patients underwent 430 pulmonary metastasectomies with curative intent. The clinical records of all patients who underwent radical lymph node dissection or sampling were reviewed retrospectively. Survival was evaluated using the Kaplan-Meier method and comparison of survival curves by log-rank test. Results: A total of 124 patients (61 men, mean age 59 years) underwent 139 pulmonary metastasectomies (56 wedge resections, 30 segmentectomies, 49 lobectomies, and 4 pneumonectomies with radical lymph node dissection [88] or sampling [51]). Means of 9.4 lymph nodes and 2 lung metastases per intervention were removed. The median disease-free interval from primary treatment to lung metastasectomy was 49 months. Lymph node involvement was present in 25 patients (20%), in 10 (8%) at N1 stations (hilar or peribronchial) and in 15 (12%) at N2 stations (mediastinal), and in 7 (12.5%) after atypical resection and in 19 (23%) after typical resection. In 15 patients (12%) (60% of N+ patients), lymph node involvement was unexpected. Estimated overall 5-year survival was 46%: It was 60% for subjects with no lymph node metastasis and 17% and 0% for those with N1 and N2 disease, respectively (P = .01). Conclusions: Lymph node involvement heavily affects prognosis after pulmonary metastasectomies. In most patients, lymph node involvement was not revealed by preoperative workup.
| Original language | English |
|---|---|
| Pages (from-to) | 967-972 |
| Number of pages | 6 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Volume | 133 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2007 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Surgery
Cite this
Prognostic role of lymph node involvement in lung metastasectomy. / Veronesi, Giulia; Petrella, Francesco; Leo, Francesco; Solli, Piergiorgio; Maissoneuve, Patrick; Galetta, Domenico; Gasparri, Roberto; Pelosi, Giuseppe; De Pas, Tommaso; Spaggiari, Lorenzo.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 133, No. 4, 04.2007, p. 967-972.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prognostic role of lymph node involvement in lung metastasectomy
AU - Veronesi, Giulia
AU - Petrella, Francesco
AU - Leo, Francesco
AU - Solli, Piergiorgio
AU - Maissoneuve, Patrick
AU - Galetta, Domenico
AU - Gasparri, Roberto
AU - Pelosi, Giuseppe
AU - De Pas, Tommaso
AU - Spaggiari, Lorenzo
PY - 2007/4
Y1 - 2007/4
N2 - Objective: The impact of lymph node involvement in lung metastasectomy from extrapulmonary malignancies is uncertain. We assessed the prognostic value of lymph node status in lung metastasectomy and the prevalence of unexpected mediastinal lymph node involvement after lymph node sampling or dissection. Methods: From May 1998 to October 2005, 388 patients underwent 430 pulmonary metastasectomies with curative intent. The clinical records of all patients who underwent radical lymph node dissection or sampling were reviewed retrospectively. Survival was evaluated using the Kaplan-Meier method and comparison of survival curves by log-rank test. Results: A total of 124 patients (61 men, mean age 59 years) underwent 139 pulmonary metastasectomies (56 wedge resections, 30 segmentectomies, 49 lobectomies, and 4 pneumonectomies with radical lymph node dissection [88] or sampling [51]). Means of 9.4 lymph nodes and 2 lung metastases per intervention were removed. The median disease-free interval from primary treatment to lung metastasectomy was 49 months. Lymph node involvement was present in 25 patients (20%), in 10 (8%) at N1 stations (hilar or peribronchial) and in 15 (12%) at N2 stations (mediastinal), and in 7 (12.5%) after atypical resection and in 19 (23%) after typical resection. In 15 patients (12%) (60% of N+ patients), lymph node involvement was unexpected. Estimated overall 5-year survival was 46%: It was 60% for subjects with no lymph node metastasis and 17% and 0% for those with N1 and N2 disease, respectively (P = .01). Conclusions: Lymph node involvement heavily affects prognosis after pulmonary metastasectomies. In most patients, lymph node involvement was not revealed by preoperative workup.
AB - Objective: The impact of lymph node involvement in lung metastasectomy from extrapulmonary malignancies is uncertain. We assessed the prognostic value of lymph node status in lung metastasectomy and the prevalence of unexpected mediastinal lymph node involvement after lymph node sampling or dissection. Methods: From May 1998 to October 2005, 388 patients underwent 430 pulmonary metastasectomies with curative intent. The clinical records of all patients who underwent radical lymph node dissection or sampling were reviewed retrospectively. Survival was evaluated using the Kaplan-Meier method and comparison of survival curves by log-rank test. Results: A total of 124 patients (61 men, mean age 59 years) underwent 139 pulmonary metastasectomies (56 wedge resections, 30 segmentectomies, 49 lobectomies, and 4 pneumonectomies with radical lymph node dissection [88] or sampling [51]). Means of 9.4 lymph nodes and 2 lung metastases per intervention were removed. The median disease-free interval from primary treatment to lung metastasectomy was 49 months. Lymph node involvement was present in 25 patients (20%), in 10 (8%) at N1 stations (hilar or peribronchial) and in 15 (12%) at N2 stations (mediastinal), and in 7 (12.5%) after atypical resection and in 19 (23%) after typical resection. In 15 patients (12%) (60% of N+ patients), lymph node involvement was unexpected. Estimated overall 5-year survival was 46%: It was 60% for subjects with no lymph node metastasis and 17% and 0% for those with N1 and N2 disease, respectively (P = .01). Conclusions: Lymph node involvement heavily affects prognosis after pulmonary metastasectomies. In most patients, lymph node involvement was not revealed by preoperative workup.
UR - http://www.scopus.com/inward/record.url?scp=33947277296&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33947277296&partnerID=8YFLogxK
U2 - 10.1016/j.jtcvs.2006.09.104
DO - 10.1016/j.jtcvs.2006.09.104
M3 - Article
C2 - 17382635
AN - SCOPUS:33947277296
VL - 133
SP - 967
EP - 972
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
SN - 0022-5223
IS - 4
ER -