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Related Experiment Videos

Pulmonary metastasectomy for pediatric solid tumors.

R M Abel1, J Brown, B Moreland

  • 1Department of Pediatric Surgery, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, UK.

Pediatric Surgery International
|July 20, 2004
PubMed
Summary

Pulmonary metastasectomy in children with isolated lung metastases from solid tumors is safe and effective. Aggressive surgical management, as part of combined therapy, leads to good long-term outcomes for most pediatric patients.

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Area of Science:

  • Pediatric Oncology
  • Thoracic Surgery
  • Surgical Oncology

Background:

  • Pediatric thoracic malignancy often presents as pulmonary disease secondary to childhood solid tumors.
  • Management of isolated pulmonary metastases in adults is established, but long-term outcomes in children are less documented.

Purpose of the Study:

  • To assess the long-term outcomes of pulmonary metastasectomy in pediatric patients with isolated pulmonary metastases.
  • To evaluate the safety and efficacy of surgical intervention for lung metastases in children.

Main Methods:

  • Retrospective study of 20 children undergoing surgery for isolated pulmonary metastases over 12 years.
  • Analysis of patient demographics, tumor types (Wilms' tumor, osteogenic sarcoma, rhabdomyosarcoma, hepatoblastoma, teratoma), surgical procedures, and follow-up data.

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  • Inclusion of preoperative imaging (contrast-enhanced CT of head and chest, chest X-ray) in assessment.
  • Main Results:

    • 16 out of 20 children remain alive and well with a mean follow-up of 8 years.
    • 19 children were discharged within 10 days of surgery, indicating good tolerance.
    • One early complication (pneumonia) and four late deaths due to cranial metastases were reported.

    Conclusions:

    • Results support an aggressive surgical approach for isolated pulmonary metastases in children as part of combined therapy.
    • Bilateral synchronous and metachronous thoracotomy is well tolerated in the pediatric population.
    • Comprehensive preoperative assessment, including advanced imaging, is crucial for surgical planning.