Pulmonary metastasectomy in pediatric patients.
This article describes the historical development of pediatric pulmonary metastasectomy but demonstrates that progress has been slow in understanding its proper applications. Because many pediatric metastatic tumors are rare, surgeons have grouped together patients of different histologies for the generation and analysis of case series. By examining tumor types individually, however, it is seen that certain histologies (adrenocortical carcinoma, alveolar soft part sarcoma, osteosarcoma) mandate surgical metastasectomy for patient survival. Other pediatric tumors (Wilms tumor, Ewing's sarcoma) are radiation sensitive, and the application of metastasectomy is controversial. In the case of still other types of tumor (neuroblastoma, differentiated thyroid cancer, rhabdomyosarcoma), metastasectomy is seldom performed except in highly unusual situations. Techniques for minimally invasive biopsy and for muscle-sparing thoracotomy are described for pediatric patients.
Kayton
Mark L
ML
Division of Pediatric Surgery, Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA. kaytonm@mskcc.org
D001706:Biopsy; D002648:Child; D006801:Humans; D007223:Infant; D008175:Lung Neoplasms / Q000175:diagnosis / Q000556:secondary* / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures; D018193:Neoplasms, Complex and Mixed / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D013510:Pulmonary Surgical Procedures; D012509:Sarcoma / Q000175:diagnosis / Q000556:secondary / Q000601:surgery