title: Lung metastasectomy: long-term outcomes in an 18-year cohort from a single center.
abstract: Lung metastasectomy is an area of interest and controversy in surgical oncology. Most of the available evidence derives from small cohorts with short follow-up. The aim of this study was to evaluate the oncologic outcomes in an 18-year cohort from a single center. We retrospectively reviewed 398 patients with several malignancies who underwent lung metastasectomy between January 1990 and December 2008. Demographic, clinical, and surgical variables were evaluated. Uni- and multivariate analyses were performed to identify factors associated with overall survival (OS). Mean follow-up was 20 months. Wedge resection was performed in 297 cases and 101 required anatomic resections. In 303 patients the disease-free interval (DFI) was >6 months meanwhile 95 patients had a DFI ≤6 months. Complete resection was achieved in 351 patients (88.2%). Median OS for all patients was 81.9 months (95% CI, 36.9-126.9). On multivariate analysis, factors associated with a poor overall survival were DFI <6 months (HR, 1.74; 95% CI, 1.24-2.4; p=0.001) and incomplete resection (HR, 1.58 95% CI, 1.01-2.5; p=0.0047). Independent prognostic factors associated with better survival were DFI >6 months and complete resection. Size and number of metastases as well as re-do metastasectomy were not associated with worse survival.
authors: Department of Surgical Oncology, Instituto Nacional de Cancerología (INCan), Av. San Fernando No. 22, Col. Sección XVI, Tlalpan, 14080 México, D.F., Mexico City, Mexico.
authors: José Francisco
authors: JF
authors: Corona-Cruz
authors: Luis Manuel
authors: LM
authors: Domínguez-Parra
authors: David
authors: D
authors: Saavedra-Pérez
authors: Edgardo
authors: E
authors: Jiménez-Fuentes
authors: Cynthia
authors: C
authors: Villarreal-Garza
authors: León
authors: L
authors: Green-Schneeweis
authors: Miguel
authors: M
authors: Ríos-Trejo
authors: Digna
authors: D
authors: Pachuca
authors: Héctor
authors: H
authors: Martínez-Said
authors: Enrique
authors: E
authors: Guzmán-de-Alba
authors: Alejandro Eduardo
authors: AE
authors: Padilla-Rosciano
authors: Oscar
authors: O
authors: Arrieta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D059146:Metastasectomy / Q000379:methods* / Q000401:mortality; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult