Abstract
Objective: Secondary pulmonary neoplasms operated in our clinic were evaluated. The effect of pulmonary metastasectomy on survival was investigated.
Material and Methods: In this study, between January 2010 and January 2015 in our clinic 29
cases operated for secondary pulmonary neoplasm were evaluated retrospectively.
Cases were individually analysed according to their demographics. Our analysis
criteria were age, gender, histopathological type of primary tumor, stage of
secondary tumor and its preoperative radiological signs, length of life without
illness, types of surgical incision and resection, numbers of
complete-incomplete resections, number of pre/postoperative nodules,
cardiopulmonary evaluations and length of survival.
Results: 20 (69%) and 9
(31%) of our cases were male and female; respectively. Youngest case was 18
years old whereas oldest case was 75 years old. Mean age of cases was 56±12
years. Number of our cases was 29 and they had undergone 38 surgical
intervention.
Most common surgical intervention was
posterolateral thoracotomy (PLT) in 24 cases. Secondary most common surgical
intervention was Video Assisted Thoracoscopic Surgery (VATS) in 14 cases.
In terms of histopathological type of primary
tumor, most common types were carcinoma (79.3%) and sarcoma (17.2%). 5-year
survival rate in pulmonary metastasectomy was 40% in sarcomas and 73.5% in
carcinomas. It was observed that pulmonary metastasectomy was more beneficial
in carcinomas than sarcomas.
Conclision: In conclusion, metastasectomy significantly improves
survival in secondary pulmonary neoplasm cases whose primary malignancy is
under control without metastasis in any other extrapulmonary area. Stage of
secondary tumor and histopathological type of primary tumor were observed as
actual factors determining survival.
References
- Pastorino U, Friedel G, Buyse M, Ginsberg RJ, Girard P, Goldstraw P, Johnston M, Mc Cormack P, Pass H, Putnam JB, Toomes H. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. The International Registry of Lung Metastases. J Thorac Cardiovasc Surg. 1997; 113,37-49.
- Putnam JB Jr. Secondary Tumors of The Lung. In Shields TW, Locicero J, Ponn RB, editors. General Thoracic Surgery. 6th ed. Philadelphia: Lippincott Williams & Wilkins 2005; 1831-62.
- Yüksel M, Kalaycı G. Metastatik akciğer tümörleri. İn: Yüksel M, Kalaycı G (eds). Göğüs Cerrahisi. İstanbul: Bilmedya Grup, 2001: 307-328.
- Margaritora S, Porziella V, D'Andrilli A, et al. Pulmonary metastases: can accurate radiological evaluation avoid thoracotomic approach? Eur J Cardiothorac Surg 2002; 21: 1111-1114.
- Parsons AM, Detterbeck FC, Parker LA. Accuracy of helical CT in the detection of pulmonary metastases: is intraoperative palpation still necessary? Ann Thorac Surg 2004; 78: 1910-1918. 6. Kondo H, Okumura T, Ohde Y, Nakagawa K. Surgical treatment for metastatic malignancies. Pulmonary metastasis: indications and outcomes. İnt J Clin Oncol. 2005; 10:81-5.
- Okur E, Cankurtaran M, Baysungur V, Kır A, Halezeroğlu S, Atasalihi A. Metastatik akciğer tümörlerinde cerrahi tedavi ToraksDergisi 2002;3:132-7. 55
- Younes RN, Haddad F, Ferreira F, Gross JL. Surgical removal of pulmonary metastases: a prospective study in 182 patients. Rev Assoc Med Bras 1998;44:218–25.
- Gross BH, Glazer GM, Bookstein FL. Multiple pulmonary nodules detected by computed tomography: diagnostic implications. J Comput Assist Tomogr. 1985; 9: 880-5.
- Kandioler D, Kromer E, Tuchler H, et al: Long term results after repeated surgical removal of pulmonary metastases. Ann Thorac Surg 65:909-12, 1998
- Weinlechner JW. Zur kasuistik der tumoren an der brustwand and deren behandlung.(Resektion der rippen, Eroffnung der Brusthohle, partielle Entfernung der Lungen). Wien Med Wochenschr 1882; 32: 589
- Godzinski J, Tournade MF, De Kraker J, Ludwig R, Weirich A, Voute PA, et al. The role of preoperative chemotherapy in the treatment of nephroblastoma: the SIOP experience. Societe Internationale d’Oncologie Pediatrique. Semin Urol Oncol 1999; 17: 28-32. 64
- Staren ED, Salerno C, Rongione A, Witt TR, Faber P. Pulmonary resection for metastatic breast cancer. Arch Surg 1992 for metastatic breast cancer. Arch Surg 1992; 127:1282-4. 67
- Marincola FM, Mark James BD. Selection factors resulting in improved survival after surgical resection of tumors metastatic to the lungs. Arch Surg. 1990; 125:1387-1393
- Epub ahead of print]. Growth rate of pulmonary metastases from soft tissue sarcoma. Rööser B, Pettersson H, Alvegård T. Acta Oncol 1987;26(6):496
- Alexander J, Haight C. Pulmonary resection for solitary metastatic sarcoma and carcinoma. Surg Gynecol Obstet 1947; 83: 129-146.
- Abecasis N, Cortez F, Bettencourt A, Costa CS, Orvalho F, Almedia JM. Surgical treatment of lung metastases: prognostic factors for long-term survival. J Surg Oncol. 1999; 72: 193-8.
- Margaritora S, Porziella V, D’Andrilli A, Cesario A, Galetta D, Macis G, et al. Pulmonary metastases: can accurate radiological evaluation avoid thoracotomic approach? Eur J Cardiothorac Surg. 2002;21:1111-4.
- Younes RN, Gross JL, Taira AM, Martins AAC, Neves GS. Surgical resection of lung metastases: results from 529 patients. Clinics 2009;64:535–41.
- Snyder BJ, Pugatch RD. Imaging characteristics of metastatic diseases to the chest. Chest Surg Clin N Am 1998; 8: 29-33.
- Mery CM, Pappas AN, Bueno R, et al: Relationship between a history of antecedent cancer and the probability of malignancy for a solitary pulmonary nodule. Chest 125:2175-81, 2004.
Abstract
Amaç: Kliniğimizde opere edilen sekonder akciğer neoplazmları incelenerek, primer tümör kontrol altında ikenyapılan metaztazektominin sağkalım üzerine olan etkilerinin araştırılması.
Materyal metod: Bu çalışmada Ocak 2010 ile Ocak 2015 yılları arasında kliniğimizde sekonder pulmoner neoplazm nedeni ile opere edilen 29 olgu retrospektif olarak incelendi. Olgular yaş, cinsiyet, kardiopulmoner değerlendirmeler, primer tümörün histopatolojik tipi, sekonder tümörün evresi ve preoperatif radyolojik bulguları, hastalıksız yaşam süreleri, cerrahi insizyon şekilleri ve rezeksiyonun türü, komplet-inkomplet rezeksiyon sayıları, nodül sayıları, sağkalım süreleri açısından değerlendirildi.
Bulgular: Olguların 9’u kadın (%31) 20’si (%69) erkek idi. En küçük yaş 18 en büyük yaş 75 (ortalama 56±12) idi.
Olgularımıza toplam 38 cerrahi girişim uygulandı. En sık uygulanan cerrahi girişim 24 olguda (%63,2) posterolateral torakotomi (PLT), 14 olguda (%36,8) video yardımlı torakoskopik cerrahi (VATS) idi. Bir yıllık sağkalım %96, 3 yıllık sağkalım %72 ve 5 yıllık sağkalım % 58 olarak bulundu. Primer tümörün histopatolojik tipine göre en sık karsinom (%79,3) ikinci sıklıkta sarkom (%17,2) tespit edildi.Sarkomlarda pulmoner metastazektominin 5 yıllık sağkalım %40, karsinomlarda %73,5 olarak hesaplandı.
Sonuç: Primer malignitesi kontrol altında ve ekstra pulmoner metastazı olmayan sekonder pulmoner neoplazmlı olgularda, metastazektomi, özellikle karsinomlarda sağkalıma önemli ölçüde katkı sağlanmaktadır. Çalışmamızda sekonder tümörün evresinin ve primer tümörün histopatolojik tipinin sağkalımı belirleyen esas faktörler olduğu görüldü.
Keywords
References
- Pastorino U, Friedel G, Buyse M, Ginsberg RJ, Girard P, Goldstraw P, Johnston M, Mc Cormack P, Pass H, Putnam JB, Toomes H. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. The International Registry of Lung Metastases. J Thorac Cardiovasc Surg. 1997; 113,37-49.
- Putnam JB Jr. Secondary Tumors of The Lung. In Shields TW, Locicero J, Ponn RB, editors. General Thoracic Surgery. 6th ed. Philadelphia: Lippincott Williams & Wilkins 2005; 1831-62.
- Yüksel M, Kalaycı G. Metastatik akciğer tümörleri. İn: Yüksel M, Kalaycı G (eds). Göğüs Cerrahisi. İstanbul: Bilmedya Grup, 2001: 307-328.
- Margaritora S, Porziella V, D'Andrilli A, et al. Pulmonary metastases: can accurate radiological evaluation avoid thoracotomic approach? Eur J Cardiothorac Surg 2002; 21: 1111-1114.
- Parsons AM, Detterbeck FC, Parker LA. Accuracy of helical CT in the detection of pulmonary metastases: is intraoperative palpation still necessary? Ann Thorac Surg 2004; 78: 1910-1918. 6. Kondo H, Okumura T, Ohde Y, Nakagawa K. Surgical treatment for metastatic malignancies. Pulmonary metastasis: indications and outcomes. İnt J Clin Oncol. 2005; 10:81-5.
- Okur E, Cankurtaran M, Baysungur V, Kır A, Halezeroğlu S, Atasalihi A. Metastatik akciğer tümörlerinde cerrahi tedavi ToraksDergisi 2002;3:132-7. 55
- Younes RN, Haddad F, Ferreira F, Gross JL. Surgical removal of pulmonary metastases: a prospective study in 182 patients. Rev Assoc Med Bras 1998;44:218–25.
- Gross BH, Glazer GM, Bookstein FL. Multiple pulmonary nodules detected by computed tomography: diagnostic implications. J Comput Assist Tomogr. 1985; 9: 880-5.
- Kandioler D, Kromer E, Tuchler H, et al: Long term results after repeated surgical removal of pulmonary metastases. Ann Thorac Surg 65:909-12, 1998
- Weinlechner JW. Zur kasuistik der tumoren an der brustwand and deren behandlung.(Resektion der rippen, Eroffnung der Brusthohle, partielle Entfernung der Lungen). Wien Med Wochenschr 1882; 32: 589
- Godzinski J, Tournade MF, De Kraker J, Ludwig R, Weirich A, Voute PA, et al. The role of preoperative chemotherapy in the treatment of nephroblastoma: the SIOP experience. Societe Internationale d’Oncologie Pediatrique. Semin Urol Oncol 1999; 17: 28-32. 64
- Staren ED, Salerno C, Rongione A, Witt TR, Faber P. Pulmonary resection for metastatic breast cancer. Arch Surg 1992 for metastatic breast cancer. Arch Surg 1992; 127:1282-4. 67
- Marincola FM, Mark James BD. Selection factors resulting in improved survival after surgical resection of tumors metastatic to the lungs. Arch Surg. 1990; 125:1387-1393
- Epub ahead of print]. Growth rate of pulmonary metastases from soft tissue sarcoma. Rööser B, Pettersson H, Alvegård T. Acta Oncol 1987;26(6):496
- Alexander J, Haight C. Pulmonary resection for solitary metastatic sarcoma and carcinoma. Surg Gynecol Obstet 1947; 83: 129-146.
- Abecasis N, Cortez F, Bettencourt A, Costa CS, Orvalho F, Almedia JM. Surgical treatment of lung metastases: prognostic factors for long-term survival. J Surg Oncol. 1999; 72: 193-8.
- Margaritora S, Porziella V, D’Andrilli A, Cesario A, Galetta D, Macis G, et al. Pulmonary metastases: can accurate radiological evaluation avoid thoracotomic approach? Eur J Cardiothorac Surg. 2002;21:1111-4.
- Younes RN, Gross JL, Taira AM, Martins AAC, Neves GS. Surgical resection of lung metastases: results from 529 patients. Clinics 2009;64:535–41.
- Snyder BJ, Pugatch RD. Imaging characteristics of metastatic diseases to the chest. Chest Surg Clin N Am 1998; 8: 29-33.
- Mery CM, Pappas AN, Bueno R, et al: Relationship between a history of antecedent cancer and the probability of malignancy for a solitary pulmonary nodule. Chest 125:2175-81, 2004.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Araştırma Makaleleri |
| Authors | |
| Publication Date | July 8, 2020 |
| Submission Date | January 3, 2020 |
| Acceptance Date | January 29, 2020 |
| Published in Issue | Year 2020 Volume: 15 Issue: 2 |
