Author of

• 10907

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  P1.16 - Poster Session 1 - Other Thoracic Malignancies (ID 186)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Thymoma & Other Thoracic Malignancies
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/28/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 10909

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    P1.16-002 - Histological impact of primary tumor on indication of repeated pulmonary metastasectomy (ID 1346)

    09:30 - 09:30  |  Author(s): T. Kato
    • Abstract

    Background
    Lung is one of the most common metastatic sites from malignances. Although efficacy of pulmonary metastasectomy (PM) has been reported recently, the prevalence has not been enough among thoracic surgeons. Moreover, beneficial effects of repeated PMs for longer survivals have been poorly evaluated. The aims of this study are to examine the efficacy of repeated PMs (Re-PM) for re-recurred diseases and evaluate the histological impact of the primary tumor on the treatment.

    Methods
    We retrospectively reviewed 263 patients who underwent PMs for various malignancies from 1996 through 2011. These factors below were evaluated; age, gender, origin of primary tumors, disease free interval (DFI) to the first PM, surgical procedure of PM, number of resected tumors, frequency of PMs, DFI after the first PM, overall survival after the first PM and prognosis.

    Results
    Among 263 patients, 166 were male, and 98 were female. The median age was 60　years old (range: 7-85). Origins of primary tumors were following; 91 colorectum, 54 bone and soft tissue, 22 head and neck, 20 adnexa uteri, 17 urinary tract, 14 testis (germ cell tumor), 45 others. Mean number of resected nodules at the first PM was one, and the maximum was 19. Wedge resections were performed most frequently in 159 patients (60%), lobectomies in 69 (26%), segmentectomies in 32 (12%), and bilobectomies in 5 (2%). Re-PMs were indicated in 47 patients (18%). Among them, while the prevalence of Re-PM was 20% (18/91) in colorectal cancer patients, that is as high as 37% (20/54) in bone and soft tissue sarcoma patients. Estimated five-year survival rate of the whole patients was 50.6%. And that of patients without recurrence, with Re-PM and without Re-PM were 92.9, 58.5 and 14.5%, respectively. In univariate analyses, sublober resection of the first PM, DFI and presence of complete resection at the first PM were significant favorable factors for overall survival. In the multivariate analysis, sublober resection and presence of complete resection at the first PM were revealed to be the independent prognostic factors.

    Conclusion
    The large portion of Re-PM patients had colorectal cancer, or bone and soft tissue sarcoma as their primary tumor. Re-PM may improve the survival of selected patients who experienced re-recurrence in lung after PM. Primary tumor of bone and soft tissue sarcoma were the most applicable histology for Re-PM.