title: Survival and Local Recurrence After Video-Assisted Thoracoscopic Lung Metastasectomy.
abstract: BACKGROUND
  Pulmonary metastasectomy is increasingly performed in selected patients by video-assisted thoracic surgery (VATS) on the base of thin-slice high-resolution CT-Scan (HRCT). This study determines the overall survival and ipsilateral recurrence rate and of patients undergoing after VATS lung metastasectomy.
  
  
  METHODS
  Retrospective single institution study of all patients who underwent VATS pulmonary metastasectomy on the base of HRCT with curative intent between 2005 and 2014.
  
  
  RESULTS
  Seventy-seven patients (41 males, 36 females) underwent VATS pulmonary metastasectomy for solitary (n = 63) or multiple (n = 14) lung metastases in the context of colorectal carcinoma (n = 26), sarcoma (n = 17), melanoma (n = 16), or other primaries (n = 18). Nine patients had bilateral lung metastases and underwent synchronous (n = 4) or sequential (n = 5) VATS resections. Preoperative CT-guided hook wire localization of the lesions was performed in 65 patients (84 %). The postoperative mortality and morbidity rates were 0 and 5.2 %, respectively. During a mean follow-up time of 24 months (range 1–120 months), tumor progression occurred in 46 patients. Twenty-three patients (30 %) had pulmonary recurrence only, of them, eight patients (10 %) in the operated lungs. Seven of eight patients with recurrence in the operated lungs underwent a second metastasectomy by VATS (n = 5) or thoracotomy (n = 2). The overall 5-year survival rate was 54 % and without difference between patients without tumor recurrence and those with pulmonary recurrence treated by re-metastasectomy.
  
  
  CONCLUSIONS
  Ipsilateral recurrence remains low after VATS pulmonary metastasectomy guided by preoperative HRCT and can be efficiently treated by re-metastasectomy.
authors.forename: Etienne
authors.initials: E
authors.lastname: Abdelnour-Berchtold
authors.forename: Jean Yannis
authors.initials: JY
authors.lastname: Perentes
authors.forename: Hans-Beat
authors.initials: HB
authors.lastname: Ris
authors.forename: Catherine
authors.initials: C
authors.lastname: Beigelman
authors.forename: Alban
authors.initials: A
authors.lastname: Lovis
authors.forename: Solange
authors.initials: S
authors.lastname: Peters
authors.forename: Thorsten
authors.initials: T
authors.lastname: Krueger
authors.forename: Michel
authors.initials: M
authors.lastname: Gonzalez
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D008297:Male; D008545:Melanoma / Q000556:secondary*; D059146:Metastasectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000556:secondary / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012509:Sarcoma / Q000556:secondary*; D015996:Survival Rate; D020775:Thoracic Surgery, Video-Assisted; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D055815:Young Adult