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. 2024 Jun;19(2):254-265.
doi: 10.5114/wiitm.2024.140300. Epub 2024 Jun 5.

Outcomes of minimally invasive surgery for pulmonary metastasis: who benefits the most?

Burcu Kılıç  1 , Ömer Faruk Sağlam  1 , Levani Chikvaidzade  1 , Ezel Erşen  1 , Hasan Volkan Kara  1 , Akif Turna  1 , Kamil Kaynak  1 , Ahmet Demirkaya  2
Affiliations

Outcomes of minimally invasive surgery for pulmonary metastasis: who benefits the most?

Burcu Kılıç et al. Wideochir Inne Tech Maloinwazyjne. 2024 Jun.

Abstract

Introduction: Metastatic disease is one of the main causes of death and factors affecting overall survival. It is known that selected patients with pulmonary oligometastases whose primary tumor is under control and who have adequate respiratory capacity may benefit from metastasectomy by resecting all detected lesions.

Aim: To report our findings on the use of video-assisted thoracoscopic surgery (VATS) for pulmonary metastasectomy, with a focus on identifying suitable candidates.

Material and methods: Between August 2010 and 2023 a total of 532 pulmonary metastasectomy procedures were performed in our institution. Metastasectomy was performed with VATS for 281 of those patients.

Results: VATS metastasectomy was performed in 131 patients with a single lesion on preoperative imaging, while 110 patients underwent metastasectomy for multiple lesions. The rate was significantly (p < 0.05) lower in the group with multiple lesions removed during surgery (38 months) than in the group with only one lesion removed during surgery (60 months). The predicted survival time in the group with other tumor histology (79 months) was significantly (p < 0.05) higher than in the groups with tumor histology carcinoma (41.4 months) and sarcoma (55.5 months).

Conclusions: The best prognosis after metastasectomy is provided in cases with a single nodule. Grade is also an important prognostic factor affecting survival, particularly for grade 1 tumor. The histopathological type of the primary tumor is also a significant prognostic factor affecting survival after pulmonary metastasectomy in secondary pulmonary neoplasms, particularly for sarcoma and carcinoma.

Keywords: minimally invasive thoracic surgery; pulmonary metastasectomy; video-assisted thoracic surgery.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Consort diagram
Figure 2
Figure 2
Number of lesion on preoperative CT – excised lesions scatter plot
Figure 3
Figure 3
Survival according to the number of preoperative CT lesions
Figure 4
Figure 4
Survival rates according to lesions removed in surgery
Figure 5
Figure 5
Survival according to single and multiple lesions
Figure 6
Figure 6
Cumulative survival rate according to tumor histology
Figure 7
Figure 7
Survial according to grades
See this image and copyright information in PMC

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References

    1. Downey RJ. Surgical treatment of pulmonary metastases. Surg Oncol Clin N Am 1999; 8: 341. - PubMed
    1. Petrella F, Diotti C, Rimessi A, Lorenzo Spaggiari L. Pulmonary metastasectomy: an overview. J Thorac Dis 2017; 9 (Suppl 12): S1291-8. - PMC - PubMed
    1. Treasure T. Pulmonary metastasectomy for colorectal cancer: weak evidence and no randomised trials. Eur J Cardiothorac Surg 2008; 33: 300-2. - PubMed
    1. Molnar TF, Gebitekin C, Turna A. What are the considerations in the surgical approach in pulmonary metastasectomy? J Thorac Oncol 2010; 5 (6 Suppl 2): S140-4. - PubMed
    1. Greenwood A, West D. Is a thoracotomy rather than thoracoscopic resection associated with improved survival after pulmonary metastasectomy? Interact CardioVasc Thorac Surg 2013; 17: 720-4. - PMC - PubMed