Abstract
Background: The role of extended pulmonary resection for lung metastases is still unclear, and little information is available in the literature. This study was performed to analyze the outcomes and prognostic factors of patients who underwent extended resections for pulmonary metastases. Methods: From 1998 to 2013, 1027 patients underwent lung metastasectomy procedures. Twenty-nine patients had extended pulmonary resections: three resections of the chest wall, one azygos, one diaphragm, four vascular resections/reconstructions, six sleeve resections, and 14 pneumonectomies. Results: Extended resection was performed for metastatic disease mainly from epithelial (62.1%) and sarcomatous (20.7%) tumors. Complete resection was obtained in all patients. Thirty-day operative morbidity and mortality rates were 38% (11 of 29) and 0%, respectively. Only one patient had a major complication due to a bronchopleural fistula. Mean hospital stay was 6.3 days. After a median follow-up of 27 months, 16 patients (55%) had died. At univariate analysis, survival was determined by primary tumor histology (p = 0.03); the number of metastases, nodal status, disease-free interval or extension of surgery (pneumonectomy vs. lobar resection) were not related to survival probably due to the low number of patients. Overall survival after a complete extended metastasectomy was 66% at 2 years, 42% at 5 years, and 36% at 10 years. Conclusions: Extended resections performed during pulmonary metastasectomies are associated with low mortality and morbidity rates and an acceptable long-term survival when performed in selected patients susceptible to complete resection.
| Original language | English |
|---|---|
| Pages (from-to) | 924-929 |
| Number of pages | 6 |
| Journal | Journal of Thoracic Oncology |
| Volume | 10 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Jun 30 2015 |
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Keywords
- Extended surgery
- Lung metastasectomy
- Morbidity and mortality
- Outcome
ASJC Scopus subject areas
- Oncology
- Pulmonary and Respiratory Medicine
Cite this
The role of extended pulmonary metastasectomy. / Casiraghi, Monica; Maisonneuve, Patrick; Brambilla, Daniela; Petrella, Francesco; Solli, Piergiorgio; Guarize, Juliana; De Marinis, Filippo; Spaggiari, Lorenzo.
In: Journal of Thoracic Oncology, Vol. 10, No. 6, 30.06.2015, p. 924-929.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The role of extended pulmonary metastasectomy
AU - Casiraghi, Monica
AU - Maisonneuve, Patrick
AU - Brambilla, Daniela
AU - Petrella, Francesco
AU - Solli, Piergiorgio
AU - Guarize, Juliana
AU - De Marinis, Filippo
AU - Spaggiari, Lorenzo
PY - 2015/6/30
Y1 - 2015/6/30
N2 - Background: The role of extended pulmonary resection for lung metastases is still unclear, and little information is available in the literature. This study was performed to analyze the outcomes and prognostic factors of patients who underwent extended resections for pulmonary metastases. Methods: From 1998 to 2013, 1027 patients underwent lung metastasectomy procedures. Twenty-nine patients had extended pulmonary resections: three resections of the chest wall, one azygos, one diaphragm, four vascular resections/reconstructions, six sleeve resections, and 14 pneumonectomies. Results: Extended resection was performed for metastatic disease mainly from epithelial (62.1%) and sarcomatous (20.7%) tumors. Complete resection was obtained in all patients. Thirty-day operative morbidity and mortality rates were 38% (11 of 29) and 0%, respectively. Only one patient had a major complication due to a bronchopleural fistula. Mean hospital stay was 6.3 days. After a median follow-up of 27 months, 16 patients (55%) had died. At univariate analysis, survival was determined by primary tumor histology (p = 0.03); the number of metastases, nodal status, disease-free interval or extension of surgery (pneumonectomy vs. lobar resection) were not related to survival probably due to the low number of patients. Overall survival after a complete extended metastasectomy was 66% at 2 years, 42% at 5 years, and 36% at 10 years. Conclusions: Extended resections performed during pulmonary metastasectomies are associated with low mortality and morbidity rates and an acceptable long-term survival when performed in selected patients susceptible to complete resection.
AB - Background: The role of extended pulmonary resection for lung metastases is still unclear, and little information is available in the literature. This study was performed to analyze the outcomes and prognostic factors of patients who underwent extended resections for pulmonary metastases. Methods: From 1998 to 2013, 1027 patients underwent lung metastasectomy procedures. Twenty-nine patients had extended pulmonary resections: three resections of the chest wall, one azygos, one diaphragm, four vascular resections/reconstructions, six sleeve resections, and 14 pneumonectomies. Results: Extended resection was performed for metastatic disease mainly from epithelial (62.1%) and sarcomatous (20.7%) tumors. Complete resection was obtained in all patients. Thirty-day operative morbidity and mortality rates were 38% (11 of 29) and 0%, respectively. Only one patient had a major complication due to a bronchopleural fistula. Mean hospital stay was 6.3 days. After a median follow-up of 27 months, 16 patients (55%) had died. At univariate analysis, survival was determined by primary tumor histology (p = 0.03); the number of metastases, nodal status, disease-free interval or extension of surgery (pneumonectomy vs. lobar resection) were not related to survival probably due to the low number of patients. Overall survival after a complete extended metastasectomy was 66% at 2 years, 42% at 5 years, and 36% at 10 years. Conclusions: Extended resections performed during pulmonary metastasectomies are associated with low mortality and morbidity rates and an acceptable long-term survival when performed in selected patients susceptible to complete resection.
KW - Extended surgery
KW - Lung metastasectomy
KW - Morbidity and mortality
KW - Outcome
UR - http://www.scopus.com/inward/record.url?scp=84938267965&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84938267965&partnerID=8YFLogxK
U2 - 10.1097/JTO.0000000000000547
DO - 10.1097/JTO.0000000000000547
M3 - Article
C2 - 26001142
AN - SCOPUS:84938267965
VL - 10
SP - 924
EP - 929
JO - Journal of Thoracic Oncology
JF - Journal of Thoracic Oncology
SN - 1556-0864
IS - 6
ER -