Surgical treatment of lung metastases: Prognostic factors for long-term survival

✍ Scribed by Abecasis, Nuno; Cortez, Fernando; Bettencourt, Antonio; Costa, Carlos Santos; Orvalho, Fernando; de Almeida, Jose Manuel Mendes

• Publisher: John Wiley and Sons
• Year: 1999
• Tongue: English
• Weight: 90 KB
• Volume: 72
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/(sici)1096-9098(199912)72:4<193::aid-jso3>3.0.co;2-8

✦ Synopsis

Background and Objectives: Surgical resection of lung metastases is an established therapy for a large number of primary tumors, but there is some controversy about prognostic factors for long-term survival. Methods: From 1968 to 1996, we performed a retrospective review of a series of 85 patients (100 operations) that have been operated for resection of lung metastases. The Kaplan-Meier method was used to estimate the probabilities of survival, the log-rank test for the univariate analysis of prognostic factors for survival, and the Cox model in the subsequent multivariate analysis. Results: The operative mortality was 4% and the morbidity 18%. The mean follow-up after lung resection was 22.13 months (1-146). The actuarial 5-year survival rate was 29.2%. By univariate analysis, the following factors were associated with survival after resection: location and histology of the primary tumor, greatest dimension of the largest metastasis, radicality of the resection, involvement of the resection margins, and use of adjuvant therapy (P < 0.05). After multivariate analysis, only the dimension of the metastases and involvement of surgical margins have been found to be independently associated with survival. Conclusions: Surgical excision is a safe and effective therapy for lung metastases from a large number of primary tumors, provided a complete resection is feasible.