State University at Campinas, Hospital de Clínicas, Campinas, Brazil.
State University at Campinas, School of Medical Sciences, Campinas, Brazil.
J Bras Pneumol. 2013 Nov-Dec;39(6):650-8. doi: 10.1590/S1806-37132013000600003.
To describe demographic characteristics, surgical results, postoperative complications, and overall survival rates in surgically treated patients with lung metastases.
This was a retrospective analysis of 119 patients who underwent a total of 154 lung metastasis resections between 1997 and 2011.
Among the 119 patients, 68 (57.1%) were male and 108 (90.8%) were White. The median age was 52 years (range, 15-75 years). In this sample, 63 patients (52.9%) presented with comorbidities, the most common being systemic arterial hypertension (69.8%) and diabetes (19.0%). Primary colorectal tumors (47.9%) and musculoskeletal tumors (21.8%) were the main sites of origin of the metastases. Approximately 24% of the patients underwent more than one resection of the lesions, and 71% had adjuvant treatment prior to metastasectomy. The rate of lung metastasis recurrence was 19.3%, and the median disease-free interval was 23 months. The main surgical access used was thoracotomy (78%), and the most common approach was wedge resection with segmentectomy (51%). The rate of postoperative complications was 22%, and perioperative mortality was 1.9%. The overall survival rates at 12, 36, 60, and 120 months were 96%, 77%, 56%, and 39%, respectively. A Cox analysis confirmed that complications within the first 30 postoperative days were associated with poor prognosis (hazard ratio = 1.81; 95% CI: 1.09-3.06; p = 0.02).
Surgical treatment of lung metastases is safe and effective, with good overall survival, especially in patients with fewer metastases.
描述接受肺转移灶切除术的患者的人口统计学特征、手术结果、术后并发症和总体生存率。
这是一项回顾性分析，纳入了 1997 年至 2011 年间接受了总共 154 例肺转移灶切除术的 119 名患者。
在这 119 名患者中，68 名（57.1%）为男性，108 名（90.8%）为白人。中位年龄为 52 岁（范围为 15-75 岁）。在该样本中，63 名（52.9%）患者合并症，最常见的是系统性动脉高血压（69.8%）和糖尿病（19.0%）。原发结直肠肿瘤（47.9%）和肌肉骨骼肿瘤（21.8%）是转移灶的主要来源。大约 24%的患者接受了不止一次的病变切除术，71%的患者在转移瘤切除术之前接受了辅助治疗。肺转移复发率为 19.3%，无病间隔中位数为 23 个月。主要手术入路是开胸术（78%），最常见的手术方式是楔形切除术联合节段切除术（51%）。术后并发症发生率为 22%，围手术期死亡率为 1.9%。12、36、60 和 120 个月的总体生存率分别为 96%、77%、56%和 39%。Cox 分析证实，术后 30 天内的并发症与预后不良相关（风险比=1.81；95%CI：1.09-3.06；p=0.02）。
肺转移灶切除术是安全有效的，总体生存率良好，尤其是在转移灶较少的患者中。
