Pulmonary metastasectomy: Might the type of resection affect survival?

Mineo, Tommaso Claudio; Ambrogi, Vincenzo; Tonini, Giuseppe; Nofroni, Italo

doi:10.1002/1096-9098(200101)76:1<47::aid-jso1008>3.0.co;2-v

Cited by 36 publications

(18 citation statements)

References 17 publications

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“…Large, non-comparative case series not included in the systematic review reported 5-year survival of 37-54% for completely resected solitary or oligometastatic pulmonary metastases. [47][48][49][50][51][52][53] Multivariate analyses consistently identifi ed a pattern of prognostic factors (panel). Having a higher number of removed pulmonary metastases, 12,51,54 concomitant mediastinal nodal metastasis, 47,[51][52][53] or incomplete resection 12,48,[51][52][53][54] was associated with poorer 5-year survival of 0-24·4%.…”

Section: Discussionmentioning

confidence: 85%

Local treatments for metastases of renal cell carcinoma: a systematic review

Dabestani

Marconi

Hofmann

et al. 2014

The Lancet Oncology

283

205

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Local treatment of metastases such as metastasectomy or radiotherapy remains controversial in the treatment of metastatic renal cell carcinoma. To investigate the benefi ts and harms of various local treatments, we did a systematic review of all types of comparative studies on local treatment of metastases from renal cell carcinoma in any organ. Interventions included metastasectomy, radiotherapy modalities, and no local treatment. The results suggest that patients treated with complete metastasectomy have better survival and symptom control (including pain relief in bone metastases) than those treated with either incomplete or no metastasectomy. Nevertheless, the available evidence was marred by high risks of bias and confounding across all studies. Although the fi ndings presented here should be interpreted with caution, they and the identifi ed gaps in knowledge should provide guidance for clinicians and researchers, and directions for further research.

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Section: Discussionmentioning

confidence: 85%

Local treatments for metastases of renal cell carcinoma: a systematic review

Dabestani

Marconi

Hofmann

et al. 2014

The Lancet Oncology

283

205

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“…While 3-and 5-year disease-free survival rate was 35.0% and 17.5%; this institutional experience was limited to eight highly selected patients with RCC PMs underwent complete pulmonary resection. Large, non-comparative previous case series reported 5-year survival of 37-54% for radically resected isolated metastases or oligo metastatic pulmonary disease (19,(25)(26)(27)(28)(29). The reasons of our remarkable 5-and 10-year survival remain unclear, but we can hypothesize that the strict selection criteria influenced results.…”

Section: Resultsmentioning

confidence: 99%

Lung metastasectomy following kidney tumors: outcomes and prognostic factors from a single-center experience

et al. 2017

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IntroductionRenal cell carcinoma (RCC) represents approximately 2% of all tumors, and about 30% of patients are affected by metastatic lesions at diagnosis (1,2). About 20% to 40% of patients develops a metastatic disease after nephrectomy (3) and lung is one of the sites most frequently affected by RCC metastases (second after liver) (4). Patients that receive no treatment for metastatic RCC (mRCC) have a 0-18% 5-year survival (5). Nonsurgical therapy for mRCC has limited efficacy, with a median overall survival (OS) reported between 26.4 and 32.0 months (6,7) for mRCC patients receiving several agents targeting angiogenesis or the mTOR pathway, in addition to traditional chemotherapeutic regimens and immunotherapy (8). On the contrary, the 5-year survival rates data published in literature after pulmonary surgery for metastasectomy from 36-54% (9,10), emphasizing the role of surgery as the Background: The lung is one of the sites most frequently affected by metastatic renal cell carcinoma

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“…The role of lung metastasectomy has been widely investigated and the treatment was accomplished in different and progressively safer modality (8,(21)(22)(23)(24). Thus, the number of pulmonary metastasectomy had significantly increased over the years.…”

Section: Discussionmentioning

confidence: 78%

“…Surgery of lung metastases is a topic that has variously stimulated our interest since 1985 when we reported our experience, based on a series collected in our previous institution, about median sternotomy in one-stage resection of bilateral lung metastases (21). Starting from that time we firstly faced the problem of the best way to resect lung investigating time-by-time laser resections (22,23) or the extent of resection in function of the survival (24). The introduction of VATS operation and the obstacle represented by the impossibility of palpating the lesion, thus favoring the probability of imaging-occult persistent metastases, stimulated us to ideate the transxiphoid access.…”

Section: Discussionmentioning

confidence: 99%

Uniportal non-intubated lung metastasectomy

Mineo¹,

Sellitri²,

Fabbi³

et al. 2017

J. Vis. Surg.

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Background: More than 15 years ago, we started a program of uniportal video-assisted thoracoscopies (VATS) lung metastasectomy in non-intubated local anesthesia. Hereby we present the short and long-term results of this combined surgical-anesthesiological technique.Methods: Between 2005 and 2015, 71 patients (37 men and 34 women) with pulmonary oligometastases, at the first episode, underwent uniportal VATS metastasectomy under non-intubated anesthesia.Results: Four patients (5.6%) required intubation for intolerance. Mean number of lesions resected per patient was 1.51. There was no mortality. The study group demonstrated a significant reduction of operative time from the beginning of the experience (P=0.001), good level of consciousness at Richmond scale and quality of recovery after both 24 and 48 hours. Median hospital stay was 3 days and major morbidity rate was 5.5%. Both disease-free survival and overall survival were similar to those achieved with intubated surgery.Conclusions: VATS lung metastasectomy in non-intubated local anesthesia was safely performed in selected patients with oligometastases with significant advantages in overall operative time, hospital stay and economical costs. Long-term results were similar.

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Pulmonary metastasectomy: Might the type of resection affect survival?

Abstract: The type of resection did not disclose statistically significant differences on survival. Minimal surgery, especially by laser device, is recommended for less morbidity.

Cited by 36 publications

References 17 publications

Local treatments for metastases of renal cell carcinoma: a systematic review

Local treatments for metastases of renal cell carcinoma: a systematic review

Lung metastasectomy following kidney tumors: outcomes and prognostic factors from a single-center experience

Uniportal non-intubated lung metastasectomy

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