Clinical effect of surgical treatment for lung metastasis and prognostic risk factor analysis: a single-centred cohort study.

Abstract

This study aimed to compare the clinical effects of lobectomy and sublobar resection in the treatment of lung metastasis and to analyse the factors affecting patient prognosis. A retrospective analysis was performed on the clinical data of patients with pulmonary metastasis who underwent thoracic surgery at the Affiliated Cancer Hospital of Xinjiang Medical University between March 2010 and May 2021. A total of 165 patients who underwent pulmonary metastasectomy (PM) for lung metastasis met the inclusion criteria. Compared with the lobectomy group, the sublobar resection group had shorter operation time for pulmonary metastases (P < 0.001), lower intraoperative blood loss (P < 0.001), lower drainage volume on the first day after surgery (P < 0.001), lower incidence of prolonged air leak (P = 0.004), shorter drainage tube indwelling time (P = 0.002), and shorter postoperative hospital stay (P = 0.023). Multivariate analysis showed that sex (95% confidence interval (CI), 0.390-0.974; P = 0.038), disease-free interval (DFI) (95% CI, 1.082-2.842; P = 0.023), and postoperative adjuvant therapy (95% CI, 1.352-5.147; P = 0.004) were independent influencing factors of disease-free survival of patients who underwent PM. DFI (95% CI, 1.062-3.894; P = 0.032) and preoperative carcinoembryonic antigen (CEA) level (95% CI, 1.420-5.163; P = 0.002) were independent factors influencing the overall survival of patients in this group. Sublobar resection provides a safe and effective treatment option for patients with pulmonary metastasis on the premise of ensuring resection of lung metastasis R0 . Female sex, longer DFI, the use of postoperative adjuvant therapy and a lower preoperative CEA level were all favourable prognostic factors.