Journal Article

Survival and Local Recurrence After Video-Assisted Thoracoscopic Lung Metastasectomy

Peters, Solange, Beigelman, Catherine, Perentes, Jean Yannis, Krueger, Thorsten, Abdelnour-Berchtold, Etienne, Ris, Hans-Beat, Gonzalez, Michel, Lovis, Alban

2016

Overview

Background Pulmonary metastasectomy is increasingly performed in selected patients by video-assisted thoracic surgery (VATS) on the base of thin-slice high-resolution CT-Scan (HRCT). This study determines the overall survival and ipsilateral recurrence rate and of patients undergoing after VATS lung metastasectomy. Patients and method Retrospective single institution study of all patients who underwent VATS pulmonary metastasectomy on the base of HRCT with curative intent between 2005 and 2014. Results Seventy-seven patients (41 males, 36 females) underwent VATS pulmonary metastasectomy for solitary ( n  = 63) or multiple ( n  = 14) lung metastases in the context of colorectal carcinoma ( n  = 26), sarcoma ( n  = 17), melanoma ( n  = 16), or other primaries ( n  = 18). Nine patients had bilateral lung metastases and underwent synchronous ( n  = 4) or sequential ( n  = 5) VATS resections. Preoperative CT-guided hook wire localization of the lesions was performed in 65 patients (84 %). The postoperative mortality and morbidity rates were 0 and 5.2 %, respectively. During a mean follow-up time of 24 months (range 1–120 months), tumor progression occurred in 46 patients. Twenty-three patients (30 %) had pulmonary recurrence only, of them, eight patients (10 %) in the operated lungs. Seven of eight patients with recurrence in the operated lungs underwent a second metastasectomy by VATS ( n  = 5) or thoracotomy ( n  = 2). The overall 5-year survival rate was 54 % and without difference between patients without tumor recurrence and those with pulmonary recurrence treated by re-metastasectomy. Conclusion Ipsilateral recurrence remains low after VATS pulmonary metastasectomy guided by preoperative HRCT and can be efficiently treated by re-metastasectomy.

• Publisher: Springer International Publishing,John Wiley & Sons, Inc
• Subject: Abdominal Surgery / Adolescent / Adult / Aged / Anatomical Resection / Cardiac Surgery / Colorectal Neoplasms - pathology / Develop Tumor Recurrence / Disease Progression / Female / General Surgery / Humans / Ipsilateral Recurrence / Lung Neoplasms - diagnostic imaging / Lung Neoplasms - secondary / Lung Neoplasms - surgery / Male / Medicine / Medicine & Public Health / Melanoma - secondary / Metastasectomy / Middle Aged / Neoplasm Recurrence, Local - diagnostic imaging / Neoplasm Recurrence, Local - secondary / Neoplasm Recurrence, Local - surgery / Original Scientific Report / Overall Survival / Pulmonary Metastasectomy / Reoperation / Retrospective Studies / Sarcoma - secondary / Surgery / Survival Rate / Thoracic Surgery / Thoracic Surgery, Video-Assisted / Thoracotomy / Tomography, X-Ray Computed / Vascular Surgery / Young Adult