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Lung resection for recurrence after pneumonectomy for metastases
D Grunenwald1, L Spaggiari, P Girard
1Service de chirurgie thoracique, Institut mutualiste Montsouris, Paris, France.
Bulletin Du Cancer
|March 1, 1997
Summary
Metastasectomy on a single lung after pneumonectomy for metastatic disease is rarely performed but can be successful in carefully selected patients. Some patients experience long-term disease-free survival, though benefits require further study.
Area of Science:
- Thoracic Surgery
- Surgical Oncology
- Pulmonary Medicine
Background:
- Resection of pulmonary metastases after prior pneumonectomy is exceptionally rare.
- This study evaluates the feasibility and outcomes of metastasectomy on a single lung in patients who have previously undergone pneumonectomy for metastatic disease.
Observation:
- Five patients (3 male, 2 female; mean age 38) with adequate FEV1 (>40%) underwent repeat lung surgery on their remaining lung.
- Procedures included wedge resections and lobectomies for various sarcomas and carcinomas, with one patient requiring cardiopulmonary bypass.
- One patient experienced a fatal postoperative complication, while others had uneventful recoveries.
Findings:
- Two patients (40%) achieved long-term disease-free survival (27 and 36 months post-surgery).
- Two other patients died within 14 months due to their disease.
- The study highlights the potential for aggressive surgical management in select cases.
Implications:
- Aggressive surgical resection of pulmonary metastases on a single lung post-pneumonectomy is feasible in carefully selected patients.
- While some patients benefit from long-term survival, the overall impact on disease-free survival needs further investigation.
- This approach may offer a therapeutic option for patients with limited choices, warranting further research into patient selection and long-term outcomes.