Characteristics associated with complete surgical resection of primary malignant mediastinal tumors.
OBJECTIVE
To identify preoperative characteristics associated with complete surgical resection of primary malignant mediastinal tumors.


METHODS
Between 1996 and 2006, 42 patients with primary malignant mediastinal tumors were submitted to surgery with curative intent at a single facility. Patient charts were reviewed in order to collect data related to demographics, clinical manifestation, characteristics of mediastinal tumors and imaging aspects of invasiveness.


RESULTS
The surgical resection was considered complete in 69.1% of the patients. Cases of incomplete resection were attributed to invasion of the following structures: large blood vessels (4 cases); the superior vena cava (3 cases); the heart (2 cases); the lung and chest wall (3 cases); and the trachea (1 case). Overall survival was significantly better among the patients submitted to complete surgical resection than among those submitted to incomplete resection. The frequency of incomplete resection was significantly higher in cases in which the tumor had invaded organs other than the lung (as identified through imaging studies) than in those in which it was restricted to the lung (47.6% vs. 14.3%; p = 0.04). None of the other preoperative characteristics analyzed were found to be associated with complete resection.


CONCLUSIONS
Preoperative radiological evidence of invasion of organs other than the lung is associated with the incomplete surgical resection of primary malignant mediastinal tumors.
Gross
Jefferson Luiz
JL
Department of Thoracic Surgery, A. C. Camargo Hospital, São Paulo, Brazil.
Rosalino
Ulisses Augusto Correia
UA
Younes
Riad Naim
RN
Haddad
Fábio José
FJ
Silva
Rodrigo Afonso da
RA
Rocha
Antonio Bomfim Marçal Avertano
AB
D000293:Adolescent; D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D008481:Mediastinoscopy / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D011300:Preoperative Care; D011859:Radiography; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000601:surgery; D013945:Thymoma / Q000000981:diagnostic imaging / Q000601:surgery; D013953:Thymus Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D055815:Young Adult