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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/5839

Title: Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases
Authors: Pastorino, U.
BUYSE, Marc
Friedel, G.
Ginsberg, R.J.
Girard, P.
Goldstraw, P.
Johnston, M.
McCormack, P.
Pass, H.
Putman, J.B.
Issue Date: 1997
Citation: Journal of thoracic cardiovascular surgery, 113(1). p. 37-49
Abstract: Objectives: The International Registry of Lung Metastases was established in 1991 to assess the long-term results of pulmonary metastasectomy. Methods: The Registry has accrued 5206 cases of lung metastasectomy, from 18 departments of thoracic surgery in Europe (n = 13), the United States (n = 4) and Canada (n = 1). Of these patients, 4572 (88%) underwent complete surgical resection. The primary tumor was epithelial in 2260 cases, sarcoma in 2173, germ cell in 363, and melanoma in 328. The disease-free interval was 0 to 11 months in 2199 cases, 12 to 35 months in 1857, and more than 36 months in 1620. Single metastases accounted for 2383 cases and multiple lesions for 2726. Mean follow-up was 46 months. Analysis was performed by Kaplan-Meier estimates of survival, relative risks of death, and multivariate Cox model. Results: The actuarial survival after complete metastasectomy was 36% at 5 years, 26% at 10 years, and 22% at 15 years (median 35 months); the corresponding values for incomplete resection were 13% at 5 years and 7% at 10 years (median 15 months). Among complete resections, the 5-year survival was 33% for patients with a disease-free interval of 0 to 11 months and 45% for those with a disease-free interval of more than 36 months; 43% for single lesions and 27% for four or more lesions. Multivariate analysis showed a better prognosis for patients with germ cell tumors, disease-free intervals of 36 months or more, and single metastases. Conclusions: These results confirm that lung metastasectomy is a safe and potentially curative procedure. Resectability, disease-free interval, and number of metastases enabled us to design a simple system of classification valid for different tumor types.
URI: http://hdl.handle.net/1942/5839
Link to publication: http://jtcs.ctsnetjournals.org/cgi/content/abstract/113/1/37
Type: Journal Contribution
Appears in Collections: Research publications

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