Abstract
BackgroundIdentification of the prognostic factors of recurrence and survival after single pulmonary metastasectomy (PM).MethodsRetrospective analysis of all consecutive patients who underwent PM for a single lung metastasis between 2003 and 2018.ResultsA 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.ConclusionsDespite 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.
Highlights
Identification of the prognostic factors of recurrence and survival after single pulmonary metastasec‐ tomy (PM)
Pulmonary metastases were synchronous in 14.2% and metachronous in 85.8% of cases
In conclusion, our results demonstrate that surgical resection of a single pulmonary metastasis is beneficial for the patients, thanks to low post-operative morbidity and mortality rates, as well as to an acceptable survival duration
Summary
Identification of the prognostic factors of recurrence and survival after single pulmonary metastasec‐ tomy (PM). Patients presenting only a single pulmonary metastasis represent 45–75% of all patients with pulmonary metastases [4, 5]. Patients with single pulmonary metastases have been reported to present a better prognosis and an increased overall survival in comparison to patients bearing multiple pulmonary metastases [5, 9,10,11]. Little is known about the recurrence rate and risk factors in this specific group of patients. Because they represent a nonnegligible sub-sample of all PM patients, and because the specific configuration of a single lung metastasis sets these patients apart in terms of possible surgical cure of their disease, we propose to focus on them only
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