Indications and Surgical Outcome Following Pulmonary Metastasectomy: A Nationwide Study

Abstract

The surgical outcome and survival of patients who underwent PM in Iceland are comparable to those in the other studies. Although there was no control group and selection bias cannot be eliminated, the survival of PM patients was better than for the nonoperated patients. However, a relatively small proportion of patients with CRC, RCC, and sarcoma underwent metastasectomy.

Expert Consensus Document on Pulmonary Metastasectomy

“…Nationwide data from Iceland described 81 patients treated for sarcoma over a 24-year period, only 5 of whom (6.5%) underwent PM. [3] Commonly reported data may identify several predictive indicators of increased survival, including: (1) metachronous versus synchronous, (2) DFI >12 months, (3) younger age, (4) limited number of metastases, (5) low pathologic grade, and (6) complete resection. [115][116][117] There is no agreed-upon number of lesions at which resection is thought to be futile, but it is likely more difficult to achieve complete resection or reach disease-free status with more lesions.…”

“…[119] Despite aggressive resection strategies, sarcoma patients with pulmonary metastases 5-year survival is only 30% -50%. [3,5,108,111,115,116,121] Many patients experience pulmonary recurrence, although there are reports of "benefit" from a second PM. [111,122] There appears to be a small survival difference for different sarcomas, with gynecological sarcomas showing better survival than osteosarcomas, which in turn have slightly improved survival compared with other sarcomas.…”

Applicability of Pulmonary Lobectomy in Treating Metastatic Lung Tumors

“…9,10) Vidarsdottir, et al reported that colorectal carcinoma, sarcoma and renal cell carcinoma were the three most common primary malignancies in their series. 11) In our series, patients with musculoskeletal metastases were younger (average ages: 39.8 years vs. 61 years), and had more multiple tumors than those with other metastases (musculoskeletal tumor vs. others: 48% vs. 26%). Lobectomies might be selected more often for musculoskeletal metastases because younger patients are considered better candidates for a less conservative procedure with a curative intent.…”

Skurðmeðferð lungnameinvarpa - yfirlitsgrein um ábendingar og árangur meðferðar

“…Í íslenskri rannsókn á 81 sjúklingi sem gekkst undir brottnám á lungnameinvörpum á árunum 1984 til 2008 voru 81,5% án einkenna, og greindust langflestir þeirra við krabbameinseftirlit þar sem gerðar voru tölvusneiðmyndir (TS) eða röntgenmyndir af lungum. 6 Greinin barst 28. september 2012, samþykkt til birtingar 20. febrúar 2013.…”

“…17 Í íslensku rannsókninni voru eitlar fjarlaegðir í aðgerð hjá þriðjungi sjúklinga en miðmaetisspeglun var aðeins framkvaemd í einu tilfelli. 6…”