Results of Pulmonary Resection

Abstract

SynopsisPulmonary metastasis can be present in as frequently as 88% and 80%, respectively, of patients with sarcoma and germ cell tumour with metastatic disease. In both sarcoma and germ cell tumour, pulmonary metastatectomy may be the only means of rendering a patient diseasefree. Sublobar (wedge or segmentectomy), lobectomy, and, rarely, pneumonectomy can be safely performed to achieve complete resection. Bilateral disease can be resected via staged thoracoscopy/thoracotomy, median sternotomy, or clamshell thoracotomy. Finally, multiple resections and re-resections in select patients have resulted in improved survival. The main principle of pulmonary metastatectomy is complete resection. In the appropriately selected patient 5-yr survival rates of as high as 35-52% for sarcoma, and 80% for germ cell tumour can be realized. -Large case series of pulmonary metastatectomy of nonseminomatous germ cell tumour (NSGCT) have reported 5-year survival rates greater than 80%.-There are no randomized trials on pulmonary metastatectomy in patients with metastatic sarcoma or NSGCT. Survival rates are from case series of selected patients without observation control arms for comparison.

Survival in adult osteosarcoma patients after resection of isolated pulmonary metastases —a single-center experience

“…Similarly, most articles on survival and prognostic factors after pulmonary metastasectomy refer to both osteosarcoma and soft tissue sarcoma together in adult patients although the biology, treatment, and prognosis of these two cancer types are different [6][7][8]. Important prognostic factors for survival after pulmonary metastasectomy include the disease-free interval, age, sex, number of lesions, time of occurrence of metastases (synchronous/metachronous), laterality of metastases, and completeness of resection [2,4,[7][8][9][10][11].…”