Is repeated pulmonary metastasectomy justified?

Details

Serval ID
serval:BIB_8CE66DC269F9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Is repeated pulmonary metastasectomy justified?
Journal
Clinical & experimental metastasis
Author(s)
Forster C., Ojanguren A., Perentes J.Y., Zellweger M., Federici S., Krueger T., Abdelnour-Berchtold E., Gonzalez M.
ISSN
1573-7276 (Electronic)
ISSN-L
0262-0898
Publication state
Published
Issued date
12/2020
Peer-reviewed
Oui
Volume
37
Number
6
Pages
675-682
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Recurrence after pulmonary metastasectomy (PM) is frequent, but it is unclear to whom repeated pulmonary metastasectomy (RPM) offers highest benefits. Retrospective analysis of oncological and post-operative outcomes of consecutive patients who underwent PM from 2003 to 2018. Overall survival (OS) and disease-free interval (DFI) were calculated. Cox regression was used to identify variables influencing OS and DFI. In total, 264 patients (female/male: 114/150; median age: 62 years) underwent PM for colorectal cancer (32%), sarcoma (19%), melanoma (16%) and other primary tumors (33%). Pulmonary metastasectomy was approached by video-assisted thoracic surgery (VATS) in 73% and pulmonary resection was realized by non-anatomical resection in 76% of cases. The overall median follow-up time was 33 months (IQR 16-56 months) and overall 5-year survival rate was 62%. Local or distant recurrences were observed in 172 patients (65%) and RPM could be performed in 66 patients (25%) for a total of 116 procedures. RPM was realized by VATS in 49% and pulmonary resection by wedge in 77% of cases. In RPM patients, the 5-year survival rate after first PM was 79%. Post-operative cardio-pulmonary complication rate (13% vs. 12%; p = 0.8) and median length of stay (4 vs. 5 days; p = 0.2) were not statistically different between first PM and RPM. Colorectal cancer (HR 0.56), metachronous metastasis (HR 0.48) and RPM (HR 0.5) were associated with better survival. In conclusion, our results suggest that RPM offers favorable survival rates without increasing post-operative morbidity.
Keywords
Pulmonary metastasectomy, Pulmonary metastases, Repeat metastasectomy, VATS
Pubmed
Web of science
Open Access
Yes
Create date
19/09/2020 13:32
Last modification date
05/05/2021 6:36
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