Pulmonary metastasectomy for sarcoma—survival and prognostic analysis

Dudek, Wojciech; Schreiner, W; Mykoliuk, Iurii; Higaze, M; Sı̂rbu, Horia

doi:10.21037/jtd.2019.08.10

Cited by 9 publications

(3 citation statements)

References 24 publications

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“…The most important is the possibility of macroscopically radical (R0) resection and, in the presence of metastases, their resectability. 25 There are no data on the results of cytoreduction surgery; however, by analogy with other sarcomas, it can be anticipated that such surgeries do not improve survival and expose patients to extensive and high-risk surgery. Cytoreduction procedure in conjunction with intraperitoneal chemotherapy is still experimental and feasible in clinical trials.…”

Section: Selection Criteria For Surgerymentioning

confidence: 99%

Management Strategies for Adults with Locally Advanced, Unresectable or Metastatic Malignant Perivascular Epithelioid Cell Tumor (PEComa): Challenges and Solutions

Czarnecka¹,

Skoczylas²,

Bartnik³

et al. 2023

CMAR

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PEComa (PEC tumor; perivascular epithelioid cell tumors) is a rare group of tumors of mesenchymal origin composed of perivascular epithelioid cells (PEC) with features of melanotic and smooth muscle differentiation. In this article, we would like to present the current treatment options for this group of tumors. PEComas are classified as tumors of uncertain malignant potential because recurrences occur after radical treatment. The primary treatment is surgical resection with negative margins. Due to the different locations of the tumors, often the cooperation of multispecialty surgeons is required during the operations. In locally advanced cases, cytoreduction and HIPEC may be effective but still are an experimental treatment. For nonresectable PEComa chemotherapy, mTOR inhibitors and VEGFR inhibitors are used.

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Section: Selection Criteria For Surgerymentioning

confidence: 99%

Management Strategies for Adults with Locally Advanced, Unresectable or Metastatic Malignant Perivascular Epithelioid Cell Tumor (PEComa): Challenges and Solutions

Czarnecka¹,

Skoczylas²,

Bartnik³

et al. 2023

CMAR

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“…This analysis is part of a series in which we have examined the survival after PM for metastatic colorectal cancer (CRC), sarcoma, and head and neck cancer before. [2][3][4]…”

Section: Introductionmentioning

confidence: 99%

Surgery for Pulmonary Metastases: Long-Term Survival in 281 Patients

Dudek

Schreiner

Khalaf

et al. 2021

Thorac Cardiovasc Surg

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Background Despite weak evidence, pulmonary metastasectomy (PM) is widely performed with intent to improve patient survival. Our single-institution analysis aims to evaluate outcomes and to identify factors influencing survival of patients undergoing PM for metastases from wide range of primary tumors. Materials and Methods All patients undergoing curative-intent PM between 2008 and 2018 were retrospectively analyzed. The impact of factors related to primary tumor, metastases, and associated therapy on overall survival (OS) was evaluated using univariable and multivariable Cox proportional hazard models. Cutoff values of continuous variables were determined by a receiver operating characteristic analysis. Results In this study, 281 patients (178 male, median age 61 years) underwent PM. Two (0.7%) perioperative deaths and 23 (8.2%) major complications occurred. Median interval between the treatment of primary tumor and PM was 21 months. Median size of largest metastasis was 1.4 cm. After the median follow-up of 29 months, 134 patients (47.7%) had died. Five-year OS rate after first PM was 47.1%. Complete resection was achieved in 274 (97.5%) patients. Multivariable analysis identified genitourinary origin (hazard ratio [HR]: 0.30, 95% confidence interval [CI]: 0.15–0.60, p = 0.0008) as independent positive survival prognosticator; incomplete resection (HR: 3.53, 95% CI: 1.40–8.91, p = 0.0077) and age at PM of ≥66 years (HR: 1.97, 95% CI: 1.36–2.85, p = 0.0003) were negative prognosticators. Conclusion The use of PM as a part of multimodal treatment is in selected population justified. Our analysis identified age, primary tumor origin, and completeness of resection as independent survival prognosticators.

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“…This analysis is part of a series in which we have examined the survival after PM for metastatic colorectal cancer and sarcoma before. 5,6…”

Section: Introductionmentioning

confidence: 99%

Survival and Prognostic Analysis after Pulmonary Metastasectomy for Head and Neck Cancer

Dudek

AlMoussa

Schreiner

et al. 2020

Thorac Cardiovasc Surg

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Background There is no consensus on the value of pulmonary metastasectomy (PM) for head and neck cancer (HNC). The aim of our single-institution study was to evaluate outcomes and to examine factors influencing 5-year survival of patients undergoing resections for HNC lung metastases. Methods All HNC patients undergoing curative-intent PM between January 2008 and December 2018 were retrospectively analyzed. The impact of factors related to primary tumor, metastases, and associated therapy on patient survival was evaluated using the univariable Cox proportional hazard model. Cutoff values of continuous variables were determined by a receiver operating characteristic analysis. Results In total, 44 patients (32 males and 12 females, with a median age of 65 years) underwent PM for metastatic HNC. There was one perioperative death, and major complications occurred in 2 (4.5%) patients. The median interval between the treatment of primary tumor and PM was 19.4 months (range: 0–151 months). Median size of the largest resected pulmonary lesion was 1.3 cm (range: 0.3–6.9 cm). Mean follow-up was 21 months (range: 0–123 months), and 5-year overall survival (OS) rate after the first PM was 41%. Resection was complete (R0) in all patients. Larger size of pulmonary metastasis (≥1.4 cm; hazard ratio: 4.49; 95% confidence interval: 1.79–11.27) was a significantly negative prognostic factor. Conclusion Despite the lack of randomized controlled trials, PM for HNC is a reasonable therapeutic option with favorable survival in a selected population. In patients with larger pulmonary lesions, shorter OS after PM is to be expected.

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Pulmonary metastasectomy for sarcoma—survival and prognostic analysis

Cited by 9 publications

References 24 publications

Management Strategies for Adults with Locally Advanced, Unresectable or Metastatic Malignant Perivascular Epithelioid Cell Tumor (PEComa): Challenges and Solutions

Management Strategies for Adults with Locally Advanced, Unresectable or Metastatic Malignant Perivascular Epithelioid Cell Tumor (PEComa): Challenges and Solutions

Surgery for Pulmonary Metastases: Long-Term Survival in 281 Patients

Survival and Prognostic Analysis after Pulmonary Metastasectomy for Head and Neck Cancer

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