Predictors of Loco-Regional Recurrence After Pulmonary Non-Anatomical Metastasectomy: A Multicentre Retrospective...

Area of Science:

• Thoracic Surgery
• Surgical Oncology
• Pulmonary Medicine

Background:

• Lung metastases resection is crucial for patient survival.
• Non-anatomical (wedge) resections are frequently employed for lung metastases.
• Predicting loco-regional recurrence after wedge resection is essential for optimizing treatment strategies.

Purpose of the Study:

• To identify predictors of loco-regional recurrence in patients undergoing wedge resection for lung metastases.
• To analyze factors influencing recurrence rates in a multicenter European cohort.
• To evaluate the impact of surgical margins and tumor characteristics on recurrence.

Main Methods:

• Multicenter retrospective analysis of 588 patients who underwent curative-intent wedge resection for lung metastases between 2010 and 2018.
• Exclusion of patients with prior metastasectomy, non-curative intent, incomplete resection, or missing recurrence data.
• Subset analysis performed on patients with solitary metastases.

Main Results:

• The 5-year loco-regional recurrence rate was 47.7%.
• In the total sample, primary tumor site, histology, resection margin width, margin-to-tumor size ratio, and number of metastases were associated with recurrence.
• In the solitary metastasis group, primary squamous-cell carcinoma histology was significantly associated with recurrence in multivariable analysis.

Conclusions:

• Loco-regional recurrence after pulmonary metastasectomy is linked to primary tumor histology and the number of metastases.
• Further investigation is required to elucidate the role of size-adjusted margin parameters in preventing recurrence.
• These findings can inform surgical decision-making and follow-up protocols for lung metastasis patients.