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. 2021 Dec 28;16(1):357.
doi: 10.1186/s13019-021-01740-3.

Survival prognostic and recurrence risk factors after single pulmonary metastasectomy

Céline Forster  1 , Amaya Ojanguren  1 , Jean Yannis Perentes  1   2 , Matthieu Zellweger  1 , Thorsten Krueger  1   2 , Etienne Abdelnour-Berchtold  1 , Michel Gonzalez  3   4
Affiliations

Survival prognostic and recurrence risk factors after single pulmonary metastasectomy

Céline Forster et al. J Cardiothorac Surg. .

Abstract

Background: Identification of the prognostic factors of recurrence and survival after single pulmonary metastasectomy (PM).

Methods: Retrospective analysis of all consecutive patients who underwent PM for a single lung metastasis between 2003 and 2018.

Results: A total of 162 patients with a median age of 64 years underwent single PM. Video-Assisted Thoracic Surgery (VATS) was performed in 83.9% of cases. Surgical resection was achieved by wedge in 73.5%, segmentectomy in 7.4%, lobectomy in 17.9% and pneumonectomy in 1.2% of cases. The median durations of hospital stay and of drainage were 4 days (IQR 3-7) and 1 day (IQR 1-2), respectively. During the follow-up (median 31 months; IQR 15-58), 93 patients (57.4%) presented recurrences and repeated PM could be realized in 35 patients (21.6%) achieved by VATS in 77.1%. Non-colorectal tumour (HR 1.84), age < 70 years (HR 1.77) and previous extra-thoracic metastases (HR 1.61) were identified as prognostic factors of recurrence. Overall survival at 5-year was estimated at 67%. Non-colorectal tumour (HR 2.40) and mediastinal lymph nodes involvement (HR 3.42) were significantly associated with an increased risk of death.

Conclusions: Despite high recurrence rates after PM, surgical resection shows low morbidity rate and acceptable long-term survival, thus should remain the standard treatment for single pulmonary metastases.

Trial registration: The Local Ethics Committee approved the study (No. 2019-02,474) and individual consent was waived.

Keywords: Pulmonary metastasectomy; Pulmonary metastases; VATS.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curve of overall survival (OS) after first single pulmonary metastasectomy (PM)
See this image and copyright information in PMC

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