title: Disease-free interval length correlates to prognosis of patients who underwent metastasectomy for esophageal lung metastases.
abstract: BACKGROUND
  Pulmonary metastasectomy is a standard method for treatment of selected pulmonary metastases cases. Nevertheless, because prognosis for patients with lung metastases from esophageal cancer who have undergone pulmonary metastasectomy is poor, candidates for this method of treatment are rare. Therefore, the efficacy of surgical treatment for pulmonary metastatic lesions from esophageal cancer has not been thoroughly examined.
  
  
  METHODS
  Between March 1984 and May 2006, 57 patients underwent resection of pulmonary metastases from primary esophageal cancer. These cases were registered in the database developed by the Metastatic Lung Tumor Study Group of Japan and were retrospectively reviewed from the registry. After excluding eight cases because of missing information, we reviewed the remaining 49 cases and examined the prognostic factors for pulmonary metastasectomy for metastases from esophageal cancer.
  
  
  RESULTS
  There were no perioperative deaths. After pulmonary metastasectomy, disease recurred in 16 (33%) of the 49 patients. The overall 5-year survival was 29.6%. Median survival time was 18 months. The survival of patients with a disease-free interval (DFI) less than 12 months was significantly lower than patients with a DFI greater than 12 months. Through multivariate analysis, we identified DFI as a clinical factor significantly related to overall survival (p = 0.04).
  
  
  CONCLUSIONS
  We identified that patients with a DFI less than 12 months who underwent pulmonary metastasectomy for metastases from esophageal cancer had a worse prognosis. Pulmonary metastasectomy for esophageal cancer should be considered for selected patients with a DFI >/=12 months.
authors.affiliation: Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan. sshiono@ypch.gr.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shiono
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kawamura
authors.forename: Toru
authors.initials: T
authors.lastname: Sato
authors.forename: Ken
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yoshino
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ikeda
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Horio
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Akiyama
authors.forename: Koichi
authors.initials: K
authors.lastname: Kobayashi