Long-term results of lung metastasectomy: Prognostic analyses based on 5206 cases

Pastorino, Ugo; Buyse, Marc; Friedel, Godehard; Ginsberg, Robert J.; Girard, Philippe; Goldstraw, Peter; Johnston, Michael; McCormack, Patricia; Pass, Harvey I.; Putnam, Joe B.

doi:10.1016/s0022-5223(97)70397-0

Cited by 1,379 publications

(950 citation statements)

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“…In general, surgery is indicated for patients in whom metastases are confined to the lung, the number of pulmonary metastases does not increase during a long follow-up period, and the primary tumor is adequately controlled. 6,7) Since the patient met all the indications for surgery, pulmonary metastasectomy was expected to improve the prognosis. For metastatic colorectal cancer, complete resection can offer only chance of cure.…”

Section: Discussionmentioning

confidence: 99%

Solitary Pulmonary Metastasis from Carcinoma of the Papilla of Vater

Goto

Urakami

Akanabe

et al. 2011

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Pulmonary metastasis from carcinoma of the papilla of Vater is considered to be a late event, and patients can be treated with radiotherapy, chemotherapy, or palliative surgery. However, surgical treatment of an isolated lung metastasis has not been reported. We present a surgical case of solitary pulmonary metastasis from carcinoma of the papilla of Vater. A 51-yearold man underwent pylorus-preserving pancreaticoduodenectomy for Vater carcinoma. During follow-up, chest computed tomography revealed a nodular shadow in the right lung. The pathological examination demonstrated the appearance of the pulmonary tumor resembled that of the previously resected Vater carcinoma, and both tumors showed similar immunostaining properties, leading to the pathological diagnosis of pulmonary metastasis from carcinoma of the papilla of Vater. Isolated pulmonary metastasis from carcinoma of the papilla of Vater is extremely rare, but surgery could be the treatment of choice.

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Section: Discussionmentioning

confidence: 99%

Solitary Pulmonary Metastasis from Carcinoma of the Papilla of Vater

Goto

Urakami

Akanabe

et al. 2011

ATCS

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“…When patients develop metastases from solid tumors, they are generally regarded as incurable [1]. However, long-term cures have been demonstrated in patients with limited metastatic disease in various different cancers [2][3][4]. An attractive consequence of the concept of oligometastases is that some patients with metastatic disease may still be curable using local therapies.…”

Section: Introductionmentioning

confidence: 99%

Stereotactic Ablative Body Radiotherapy for the Treatment of Spinal Oligometastases

et al. 2017

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After the embargo period via non-commercial hosting platforms such as their institutional repository  via commercial sites with which Elsevier has an agreement In all cases accepted manuscripts should: link to the formal publication via its DOI  bear a CC-BY-NC-ND license -this is easy to do, click here to find out how  if aggregated with other manuscripts, for example in a repository or other site, be shared in alignment with our hosting policy  not be added to or enhanced in any way to appear more like, or to substitute for, the published journal article This cohort warrants further investigation in clinical trials of SABR.

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“…The incentive for using stereotactic ablative radiotherapy (SABR) for metastatic lung lesions (MLLs) came from favorable results of surgical removal of oligometastases in different types of solid tumors (2). High rates of survival in treated compared with untreated patients have also been demonstrated for lung metastasectomy (3). However, the temporal and locational burden of oligometastatic state remains blurred and diffuse and-until now-no clear guidelines have been defined for the selection of patients who would really benefit from local ablative treatment.…”

Section: Introductionmentioning

confidence: 99%

Retrospective analysis of stereotactic ablative radiotherapy (SABR) for metastatic lung lesions (MLLs) in comparison with a contemporaneous cohort of primary lung lesions (PLLs)

et al. 2017

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Background: The net benefit from local ablative therapy for pulmonary oligometastases remains unknown.The outcomes of stereotactic ablative radiotherapy (SABR) for metastatic lung lesions (MLLs) were analyzed retrospectively and compared with those of SABR for primary lung lesions (PLLs). Methods: Medical records of patients treated with lung SABR between 2011 and 2014 were retrospectively reviewed. Basic patient, lesion and treatment characteristics were compared using the Pearson chi-square test for categorical and Mann-Whitney U test for continuous variables. To estimate the rates of local control (LC), progression-free survival (PFS), survival after the first progression post-SABR (SAPF) and overall survival (OS), the Kaplan-Meier method was used, and the differences between groups were assessed by means of the log rank test. The uni-and multivariate Cox proportional hazards regression model was used to identify predictive factors for these endpoints. Results: Twenty-nine MLLs in 18 consecutive patients and 51 PLLs in 42 patients were treated stereotactically and included in the study. Median follow-up was 14 months (range, 4-40 months). Although patients with MLLs had a significantly better cardiopulmonary function (P=0.0001), more conservative dosefractionation schedules were prescribed (P=0.0001), but this did not result in a significant difference in LC (P=0.98), PFS (P=0.06) and OS (P=0.14). Multivariate analysis revealed that the dose per fraction (≥ or <12 Gy) was an independent predictor for LC (P=0.02) and PFS (P=0.01) for the whole population, and for PFS (P=0.02) in the PLLs group. Late toxicities ≥ G2 occurred in six patients with PLLs, compared with none in the metastatic group. Conclusions: SABR for MLLs was as successful as for PLLs with respect to LC and OS with lower longterm toxicity in patients with MLLs. Dose per fraction ≥12 Gy turned out to be an independent, favorable prognostic factor. IntroductionBased on conceptual theories of breast cancer growth and dissemination, Hellman and Weichselbaum inferred the existence of a clinically and biologically relevant group of oligometastatic patients, in whom aggressive local therapy may prolong survival and even be a curative treatment option (1). The incentive for using stereotactic ablative radiotherapy (SABR) for metastatic lung lesions (MLLs) came from favorable results of surgical removal of oligometastases in different types of solid tumors (2). High rates of survival in treated compared with untreated patients have also been demonstrated for lung metastasectomy (3). However, the temporal and locational burden of oligometastatic state remains blurred and diffuse and-until now-no clear guidelines have been defined for the selection of patients who would really benefit from local ablative treatment.During the past decade, SABR emerged as a new standard of care for medically inoperable patients with early stage non-small-cell lung cancer. For oligometastatic diseases the benefit from SABR has been extrapolated from the experience with pr...

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Long-term results of lung metastasectomy: Prognostic analyses based on 5206 cases

Abstract: 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.

Cited by 1,379 publications

References 25 publications

Solitary Pulmonary Metastasis from Carcinoma of the Papilla of Vater

Solitary Pulmonary Metastasis from Carcinoma of the Papilla of Vater

Stereotactic Ablative Body Radiotherapy for the Treatment of Spinal Oligometastases

Retrospective analysis of stereotactic ablative radiotherapy (SABR) for metastatic lung lesions (MLLs) in comparison with a contemporaneous cohort of primary lung lesions (PLLs)

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