title: Outcomes and prognostic factors of survival after pulmonary resection for metastatic gastric cancer.
abstract: OBJECTIVE
  Gastric cancer is the most common malignant tumour in Japan. Because gastric cancer metastases to the lung generally occur as lymphangitic carcinomatosis or numerous lesions, metastasectomy is rarely indicated. Therefore, the role of resectable pulmonary metastasectomy in gastric cancer is still unclear. The objective of this study was to determine the surgical outcomes and prognostic factors for survival after pulmonary resection of resectable metastatic gastric cancer.
  
  
  METHODS
  The database of the Metastatic Lung Tumor Study Group of Japan was retrospectively reviewed. Between March 1980 and March 2011, 3831 patients underwent pulmonary metastasectomy. Fifty-one patients undergoing surgery for metastatic gastric cancer were analysed, and the survival parameters and prognostic factors after pulmonary metastasectomy were determined.
  
  
  RESULTS
  The median time to recurrence after lung resection was 6 months (range, 0-29 months). The overall 5-year survival rate after pulmonary metastasectomy was 28%, and the median survival time was 29 months. Both univariate and multivariate analysis found that a disease-free interval <12 months was a poor prognostic factor (P = 0.01, P = 0.04, respectively). For 43 patients with a disease-free interval ≥12 months, the 5-year survival rate was 31%.
  
  
  CONCLUSIONS
  While resectable pulmonary metastases from gastric cancer are rare, a relatively good surgical outcome is expected for selected patients with disease-free intervals longer than 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: Toru
authors.initials: T
authors.lastname: Sato
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Horio
authors.forename: Masayuki
authors.initials: M
authors.lastname: Chida
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Matsuguma
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ozeki
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.forename: Sakae
authors.initials: S
authors.lastname: Okumura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery*; D008297:Male; D059146:Metastasectomy; D008875:Middle Aged; D011013:Pneumonectomy; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology*