The role of extended pulmonary metastasectomy

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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 languageEnglish
Pages (from-to)924-929
Number of pages6
JournalJournal of Thoracic Oncology
Volume10
Issue number6
DOIs
Publication statusPublished - Jun 30 2015

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Metastasectomy
Lung
Survival
Pneumonectomy
Neoplasm Metastasis
Morbidity
Mortality
Thoracic Wall
Diaphragm
Fistula
Blood Vessels
Length of Stay
Neoplasms
Histology

Keywords

  • Extended surgery
  • Lung metastasectomy
  • Morbidity and mortality
  • Outcome

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

@article{92c1c3b2a5be4656803bb3842cc32458,
title = "The role of extended pulmonary metastasectomy",
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.",
keywords = "Extended surgery, Lung metastasectomy, Morbidity and mortality, Outcome",
author = "Monica Casiraghi and Patrick Maisonneuve and Daniela Brambilla and Francesco Petrella and Piergiorgio Solli and Juliana Guarize and {De Marinis}, Filippo and Lorenzo Spaggiari",
year = "2015",
month = "6",
day = "30",
doi = "10.1097/JTO.0000000000000547",
language = "English",
volume = "10",
pages = "924--929",
journal = "Journal of Thoracic Oncology",
issn = "1556-0864",
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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

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