Surgical resection of lung metastases: results from 529 patients

Clinics (Sao Paulo). 2009;64(6):535-41. doi: 10.1590/s1807-59322009000600008.

Abstract

Objective: The aim of this study is to determine clinical, pathological, and treatment-relevant variables associated with long-term (90-month) overall survival in patients with lung metastases undergoing pulmonary metastasectomy.

Methods: A retrospective review was performed of patients who were admitted with lung metastases, and who underwent thoracotomy for resection, after treatment of a primary tumor. Data were collected regarding demographics, tumor features, treatment, and outcome.

Results: Patients (n = 529) were submitted to a total of 776 thoracotomies. Median follow-up time across all patients was 21.6 months (range: 0-192 months). The postoperative complication rate was 9.3%, and the 30-day mortality rate was 0.2%. The ninety-month overall survival rate for all patients was 30.4%. Multivariate analysis identified the number of pulmonary nodules detected on preoperative CT-scan, the number of malignant nodules resected, and complete resection as the independent prognostic factors for overall survival.

Conclusion: These results confirm that lung metastasectomy is a safe and potentially curative procedure for patients with treated primary tumors. A select group of patients can achieve long-term survival after resection.

Keywords: Lung; Metastasectomy; Metastases; Prognostic factors; Resection.

MeSH terms

  • Adenocarcinoma / secondary*
  • Adenocarcinoma / surgery*
  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Disease-Free Survival
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Kaplan-Meier Estimate
  • Lung Neoplasms / secondary*
  • Lung Neoplasms / surgery*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Retrospective Studies
  • Thoracotomy
  • Time Factors
  • Treatment Outcome
  • Young Adult