title: A 10-year single-center experience on 708 lung metastasectomies: the evidence of the "international registry of lung metastases".
abstract: BACKGROUND
  The International Registry of Lung Metastases defined a new staging system based on identified prognostic factors for long-term survival after metastasectomy. The aim of our study was to confirm the validity of the International Registry of Lung Metastases classification system in patients who underwent curative lung metastasectomy in a single center.
  
  
  METHODS
  We retrospectively reviewed 575 patients who underwent 708 lung metastasectomies from January 1998 to October 2008. Complete curative pulmonary resections were performed in 490 cases (85%). Three hundred seventy-two patients developed lung metastases from epithelial tumors, 80 from sarcomas, 27 from melanomas, and 11 from germ cell tumors. The mean disease-free interval (DFI) was 46.6 months. Open surgical resection was performed in 479 patients. One hundred eighty-five patients had a single-lung metastasis. Lymph node dissection was performed in 353 cases.
  
  
  RESULTS
  After a mean follow-up of 34 months, 247 patients (43%) had died. Multivariate analysis disclosed that completeness of resection (p < 0.0001), patients with germ cell tumors (p = 0.04), and DFI ≥36 months (p = 0.01) were also associated with a better prognosis. The actuarial survival after complete metastasectomy was 74% at 2 years and 46% at 5 years.
  
  
  CONCLUSIONS
  We confirmed completeness of surgery, histology, and DFI ≥36 months as independent prognostic factors. Number of metastases, presence of lymph node metastases, surgical approach, and number of metastasectomies did not statistically influence long-term survival.
authors.affiliation: Thoracic Surgery Division, European Institute of Oncology, Milan, Italy. monica.casiraghi@ieo.it
authors.forename: Monica
authors.initials: M
authors.lastname: Casiraghi
authors.forename: Tommaso
authors.initials: T
authors.lastname: De Pas
authors.forename: Patrick
authors.initials: P
authors.lastname: Maisonneuve
authors.forename: Daniela
authors.initials: D
authors.lastname: Brambilla
authors.forename: Barbara
authors.initials: B
authors.lastname: Ciprandi
authors.forename: Domenico
authors.initials: D
authors.lastname: Galetta
authors.forename: Alessandro
authors.initials: A
authors.lastname: Borri
authors.forename: Roberto
authors.initials: R
authors.lastname: Gasparri
authors.forename: Francesco
authors.initials: F
authors.lastname: Petrella
authors.forename: Adele
authors.initials: A
authors.lastname: Tessitore
authors.forename: Juliana
authors.initials: J
authors.lastname: Guarize
authors.forename: Stefano Maria
authors.initials: SM
authors.lastname: Donghi
authors.forename: Giulia
authors.initials: G
authors.lastname: Veronesi
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Solli
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Spaggiari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007390:International Agencies; D008175:Lung Neoplasms / Q000556:secondary / Q000601:surgery*; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000601:surgery*; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology / Q000601:surgery*; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D012042:Registries; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18