Department of Pediatric Oncology, National Cancer Institute/ Cairo University, Cairo, Egypt.
Department of Pediatric Oncology, Children Cancer Hospital Egypt, Cairo, Egypt.
J Egypt Natl Canc Inst. 2024 Jan 22;36(1):2. doi: 10.1186/s43046-023-00198-9.
Metastatic tumors account for 80% of all lung tumors in children. Wilms tumour and osteosarcoma are the most tumors of childhood that produce lung metastases. The aim of the current study is to assess the prognostic factors of pulmonary metastatectomy in pediatric solid tumours as age, number, size, site,laterality, resectability of pulmonary nodules, and number of Thoracotomies. Calculate overall survival among patients who underwent pulmonary metastatectomy.
It is a retrospective study including all pediatric patients with metastatic solid tumors to lungs treated at pediatric oncology department, National Cancer Institute, Cairo University from 2008 to 2014. Fifty-five patients were included, 43 (78.2℅) patients of them had Osteosarcoma.
Thirty (54.5℅)patients were male. The mean age was 15 years ranging from (4.5- 23) years. The site of primary disease was at lower limbs in 43 (78.2%) patients. All patients underwent complete surgical resection of the primary disease with negative margin, 22(51.1%) of the osteosarcoma patients did amputation with tumor necrosis less than 90%. All patients received chemotherapy and only 9 received radiation therapy. The patients were classified into four groups according to time of diagnosis of pulmonary metastasis: at time of diagnosis in 13 (21.8%) patients, within treatment in 16 (30.9%) patients, within first year follow up in 18 (32.7%) patients and detected late in 8 (14.5%) patients. Bilateral lung metastasis diagnosed by CT chest were detected in 42 (76.4%) patients. Size of metastatic nodules was ranging from (0.5 to 10 cm) with mean 3.4 cm. Number of metastatic nodules was ranging from (1 to 28) median 4.Metastatic complications were detected in 19 patients. 5-year OS was 74.8% in the study group, and 68% in osteosarcoma patients. Effect of prognostic factors as sex, time of respectability, laterality, tumor necrosis of the 1ry disease, Timing of lung metastasis, size and site of the primary, Surgical approach of metastatectomy, postoperative complications on overall survival of the studied patients was done with significant P-value of tumor necrosis of the 1ry disease and Timing of lung metastasis 0.017, 0.001 respectively.
Resection of pulmonary metastases of pediatric solid tumours is a safe and effective treatment that offers better survival.
转移性肿瘤占儿童所有肺部肿瘤的 80%。Wilms 瘤和骨肉瘤是儿童最易发生肺部转移的肿瘤。本研究的目的是评估儿童实体瘤肺转移切除术的预后因素，如年龄、数量、大小、部位、侧别、肺结节的可切除性以及开胸次数。计算接受肺转移切除术的患者的总生存率。
这是一项回顾性研究，包括 2008 年至 2014 年在开罗大学国家癌症研究所儿科肿瘤科治疗的所有患有肺部转移性实体瘤的儿科患者。共纳入 55 例患者，其中 43 例（78.2%）为骨肉瘤患者。
30 例（54.5%）患者为男性。平均年龄为 15 岁，范围为（4.5-23）岁。原发疾病的部位在 43 例（78.2%）患者的下肢。所有患者均行原发疾病的完全手术切除，切缘阴性，22 例（51.1%）骨肉瘤患者行肿瘤坏死率<90%的截肢术。所有患者均接受化疗，仅 9 例接受放疗。根据肺部转移的诊断时间，患者分为四组：13 例（21.8%）患者在诊断时，16 例（30.9%）患者在治疗中，18 例（32.7%）患者在首次随访年内，8 例（14.5%）患者在晚期发现。42 例（76.4%）患者经胸部 CT 诊断为双侧肺部转移。转移结节大小为（0.5-10cm），平均 3.4cm。转移结节数为（1-28）个，中位数为 4 个。19 例患者出现转移并发症。研究组 5 年 OS 为 74.8%，骨肉瘤患者为 68%。性别、可切除性时间、侧别、1 级疾病肿瘤坏死率、肺转移时间、原发灶大小和部位、肺转移切除术手术方式、术后并发症等预后因素对研究患者的总生存的影响具有显著的 P 值（0.017，0.001）。
儿童实体瘤肺转移切除术是一种安全有效的治疗方法，可提供更好的生存。
