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.
Surg Oncol. 2012 Sep;21(3):237-44. doi: 10.1016/j.suronc.2012.05.003. Epub 2012 Jun 30.
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.
肺转移瘤切除术是肿瘤外科学中的一个研究热点和争议领域。大部分现有证据来自于随访时间短的小样本队列。本研究旨在评估单一中心 18 年队列的肿瘤学结果。我们回顾性分析了 1990 年 1 月至 2008 年 12 月期间接受肺转移瘤切除术的 398 例多种恶性肿瘤患者的临床资料。评估了人口统计学、临床和手术变量。进行了单因素和多因素分析，以确定与总生存期（OS）相关的因素。平均随访时间为 20 个月。297 例患者行楔形切除术，101 例患者行解剖性切除术。303 例患者无病间隔（DFI）>6 个月，95 例患者 DFI ≤6 个月。351 例患者达到完全切除（88.2%）。所有患者的中位 OS 为 81.9 个月（95%CI，36.9-126.9）。多因素分析显示，DFI<6 个月（HR，1.74；95%CI，1.24-2.4；p=0.001）和不完全切除（HR，1.58；95%CI，1.01-2.5；p=0.0047）与整体生存较差相关。与更好的生存相关的独立预后因素是 DFI>6 个月和完全切除。转移灶的大小和数量以及再次行转移瘤切除术与较差的生存无关。
