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Is repeated pulmonary metastasectomy justified?
Céline Forster1, Amaya Ojanguren1, Jean Yannis Perentes1,2
1Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011, Lausanne, Switzerland.
Clinical & Experimental Metastasis
|September 13, 2020
Summary
Repeated pulmonary metastasectomy (RPM) offers favorable survival rates for patients with recurrent lung tumors. This procedure does not increase post-operative complications or hospital stay compared to the initial surgery.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Pulmonary metastasectomy (PM) is a key treatment for resectable lung metastases.
- Recurrence after PM is common, leading to questions about the efficacy of repeated pulmonary metastasectomy (RPM).
Purpose of the Study:
- To evaluate the oncological and post-operative outcomes of patients undergoing PM.
- To determine the benefits and safety of repeated pulmonary metastasectomy (RPM).
Main Methods:
- Retrospective analysis of 264 patients undergoing PM between 2003 and 2018.
- Analysis of overall survival (OS) and disease-free interval (DFI) using Cox regression.
- Comparison of outcomes between initial PM and RPM procedures.
Main Results:
- 65% of patients experienced recurrence, with 25% undergoing RPM (116 procedures).
- RPM patients had a 5-year survival rate of 79% after the first PM.
- No significant differences in complication rates or length of stay between first PM and RPM.
- Colorectal cancer, metachronous metastasis, and RPM were associated with improved survival.
Conclusions:
- Repeated pulmonary metastasectomy (RPM) provides significant survival benefits for selected patients.
- RPM is a safe procedure with comparable post-operative morbidity to the initial PM.
- RPM should be considered for patients with recurrent pulmonary metastases.
