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. 2013 Nov-Dec;39(6):650-8.
doi: 10.1590/S1806-37132013000600003.

Descriptive analysis of and overall survival after surgical treatment of lung metastases

[Article in English, Portuguese]
Giana Balestro Poletti  1 , Ivan Felizardo Contrera Toro  2 , Thais Ferreira Alves  2 , Eliana Cristina Martins Miranda  2 , José Cláudio Teixeira Seabra  2 , Ricardo Kalaf Mussi  2
Affiliations

Descriptive analysis of and overall survival after surgical treatment of lung metastases

[Article in English, Portuguese]
Giana Balestro Poletti et al. J Bras Pneumol. 2013 Nov-Dec.

Abstract
in English, Portuguese

Objective: To describe demographic characteristics, surgical results, postoperative complications, and overall survival rates in surgically treated patients with lung metastases.

Methods: This was a retrospective analysis of 119 patients who underwent a total of 154 lung metastasis resections between 1997 and 2011.

Results: Among the 119 patients, 68 (57.1%) were male and 108 (90.8%) were White. The median age was 52 years (range, 15-75 years). In this sample, 63 patients (52.9%) presented with comorbidities, the most common being systemic arterial hypertension (69.8%) and diabetes (19.0%). Primary colorectal tumors (47.9%) and musculoskeletal tumors (21.8%) were the main sites of origin of the metastases. Approximately 24% of the patients underwent more than one resection of the lesions, and 71% had adjuvant treatment prior to metastasectomy. The rate of lung metastasis recurrence was 19.3%, and the median disease-free interval was 23 months. The main surgical access used was thoracotomy (78%), and the most common approach was wedge resection with segmentectomy (51%). The rate of postoperative complications was 22%, and perioperative mortality was 1.9%. The overall survival rates at 12, 36, 60, and 120 months were 96%, 77%, 56%, and 39%, respectively. A Cox analysis confirmed that complications within the first 30 postoperative days were associated with poor prognosis (hazard ratio = 1.81; 95% CI: 1.09-3.06; p = 0.02).

Conclusions: Surgical treatment of lung metastases is safe and effective, with good overall survival, especially in patients with fewer metastases.

OBJETIVO:: Descrever características demográficas, resultados operatórios, complicações pós-operatórias e taxa de sobrevida global em pacientes com metástases pulmonares tratados cirurgicamente.

MÉTODOS:: Análise retrospectiva de 119 pacientes submetidos a um total de 154 cirurgias de ressecção de metástase pulmonar entre 1997 e 2011.

RESULTADOS:: Do total de 119 pacientes, 68 (57,1%) eram do sexo masculino, e 108 (90,8%) eram brancos. A mediana de idade foi de 52 anos (variação, 15-75 anos). Nessa amostra, 63 pacientes (52,9%) apresentaram comorbidades, sendo as mais frequentes hipertensão arterial sistêmica (69,8%) e diabetes (19,0%). Tumores primários colorretais (47,9%) e musculoesqueléticos (21,8%) foram os principais sítios de origem das metástases. Aproximadamente 24% dos pacientes foram submetidos a mais de uma ressecção das lesões, e 71% fizeram tratamento adjuvante prévio à metastasectomia. A taxa de recidiva de metástase pulmonar foi de 19,3%. A mediana do intervalo livre de doença foi de 23 meses. A principal via de acesso usada foi toracotomia (78%), e o tipo de ressecção mais frequente foi em cunha e segmentectomia (51%). O índice de complicações pós-operatórias foi de 22% e o de mortalidade perioperatória foi de 1,9%. As taxas de sobrevida global em 12, 36, 60 e 120 meses foram, respectivamente, de 96%, 77%, 56% e 39%. A análise de Cox confirmou que complicações nos primeiros 30 dias pós-operatórios associaram-se a pior prognóstico (hazard ratio = 1,81; IC95%: 1,09-3,06; p = 0,02).

CONCLUSÕES:: O tratamento cirúrgico das metástases pulmonares oriundas de diferentes sítios tumorais é efetivo e seguro, com boa sobrevida global, especialmente nos casos com um menor número de lesões pulmonares.

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Figures

Figure 1
Figure 1. In A, overall survival in the groups of patients who underwent and who did not undergo chemotherapy/radiotherapy (CHT/RT) before surgery (n = 119). In B, overall survival in the groups of patients who underwent and who did not undergo CHT/RT after surgery (n = 116). In C, overall survival in the groups of patients who had and who did not have complications within 30 postoperative days (n = 119).
Figure 2
Figure 2. Overall survival by type of primary tumor.
Figura 1
Figura 1. Em A, sobrevida global nos grupos de pacientes submetidos ou não a quimioterapia/radioterapia (QT/RT) antes da cirurgia (n = 119). Em B, sobrevida global nos grupos de pacientes submetidos ou não a QT/RT depois da cirurgia (n = 116). Em C, sobrevida global nos grupos de pacientes que apresentaram ou não complicações nos em até 30 dias pós-operatórios (n = 119).
Figura 2
Figura 2. Sobrevida global nos pacientes em função do tipo de tumor primário.
See this image and copyright information in PMC

References

    1. Aberg T, Malmberg KA, Nilsson B, Nöu E. The effect of metastasectomy: fact or fiction? Ann Thorac Surg. 1980;30(4):378–384. http://dx.doi.org/10.1016/S0003-4975(10)61278-7 - DOI - PubMed
    1. Weinlechner JD. Tumorenan der brustwand und derenbehand-lung (Resektion der rippen, eroffnung der brusthohle, partielleentfernun der lunge) Wiener Med Wschr. 1882;20:589–591. (Ger).
    1. Ehrenhaft JL. Pulmonary resections for metastatic lesions. AMA Arch Surg. 1951;63(3):326–336. http://dx.doi.org/10.1001/archsurg.1951.01250040332007 - DOI - PubMed
    1. Fujisawa T, Yamaguchi Y, Saitoh Y, Sekine Y, Iizasa T, Mitsunaga S, et al. Factors influencing survival following pulmonary resection for metastatic colorectal carcinoma. Tohoku J Exp Med. 1996;180(2):153–160. http://dx.doi.org/10.1620/tjem.180.153 - DOI - PubMed
    1. Dellai RCA, Chojniak R, Marques E, Younes RN. Detecção de nódulos pulmonares por tomografia computadorizada em pacientes com metástases pulmonares submetidos à cirurgia. J Pneumol. 1994;20(Suppl 3):28–28.