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Resection of pulmonary metastases from sarcoma: can some patients benefit from a less invasive approach?
Ann Thorac Surg. 2009 Jan; 87(1):238-43.AT

Abstract

BACKGROUND

Although video-assisted metastasectomy has been proposed for some solitary metastases, its value has not been investigated in patients with pulmonary metastases from sarcoma for which open resection remains the usual approach.

METHODS

In all, 113 consecutive patients underwent curatively intended lung resection for metastases from sarcomas. Of these 113 patients, 31 were selected for a thoracoscopic wedge resection (group TS). These patients were compared with 29 patients operated on by thoracotomy but whose features could have made them possible candidates for a thoracoscopic resection (group TT). Follow-up was complete for all patients (mean follow-up, 34 months).

RESULTS

No mortality occurred. No morbidity was observed in group TT, and 1 complication occurred in group TS. The mean postoperative hospital stay was 3.7 days for group TS and 6.2 days for group TT (p < 0.0001). Overall survival rates at 1, 3, and 5 years were, respectively, 87.4%, 70.9%, and 52.5% in group TS, and 82.3%, 63.6%, and 34% in group TT (p = 0.20). Disease-free survival rates at 1 and 3 years were, respectively, 50.5% and 26.4% in group TS and 60% and 24.8% in group TT (p = 0.74). Local recurrence occurred in 1 patient in each group. Survival without a homolateral recurrence (i.e., in the operated lung) at 1 and 3 years was 66.7% and 44.4% in group TS and 83.5% and 45% in group TT, respectively (p = 0.54).

CONCLUSIONS

In selected patients with a maximum of two pulmonary nodules, thoracoscopic resections yield survival rates similar to open resections while being less invasive and preserving the patient's ability to undergo possible repeat operations.

Authors+Show Affiliations

Thoracic Department, Institut Mutualiste Montsouris, Paris, France. dominique.gossot@imm.frNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

19101304

Citation

Gossot, Dominique, et al. "Resection of Pulmonary Metastases From Sarcoma: Can some Patients Benefit From a Less Invasive Approach?" The Annals of Thoracic Surgery, vol. 87, no. 1, 2009, pp. 238-43.
Gossot D, Radu C, Girard P, et al. Resection of pulmonary metastases from sarcoma: can some patients benefit from a less invasive approach? Ann Thorac Surg. 2009;87(1):238-43.
Gossot, D., Radu, C., Girard, P., Le Cesne, A., Bonvalot, S., Boudaya, M. S., Validire, P., & Magdeleinat, P. (2009). Resection of pulmonary metastases from sarcoma: can some patients benefit from a less invasive approach? The Annals of Thoracic Surgery, 87(1), 238-43. https://doi.org/10.1016/j.athoracsur.2008.09.036
Gossot D, et al. Resection of Pulmonary Metastases From Sarcoma: Can some Patients Benefit From a Less Invasive Approach. Ann Thorac Surg. 2009;87(1):238-43. PubMed PMID: 19101304.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Resection of pulmonary metastases from sarcoma: can some patients benefit from a less invasive approach? AU - Gossot,Dominique, AU - Radu,Costin, AU - Girard,Philippe, AU - Le Cesne,Axel, AU - Bonvalot,Sylvie, AU - Boudaya,Mohamed Sadok, AU - Validire,Pierre, AU - Magdeleinat,Pierre, PY - 2008/06/18/received PY - 2008/09/11/revised PY - 2008/09/16/accepted PY - 2008/12/23/entrez PY - 2008/12/23/pubmed PY - 2009/1/23/medline SP - 238 EP - 43 JF - The Annals of thoracic surgery JO - Ann Thorac Surg VL - 87 IS - 1 N2 - BACKGROUND: Although video-assisted metastasectomy has been proposed for some solitary metastases, its value has not been investigated in patients with pulmonary metastases from sarcoma for which open resection remains the usual approach. METHODS: In all, 113 consecutive patients underwent curatively intended lung resection for metastases from sarcomas. Of these 113 patients, 31 were selected for a thoracoscopic wedge resection (group TS). These patients were compared with 29 patients operated on by thoracotomy but whose features could have made them possible candidates for a thoracoscopic resection (group TT). Follow-up was complete for all patients (mean follow-up, 34 months). RESULTS: No mortality occurred. No morbidity was observed in group TT, and 1 complication occurred in group TS. The mean postoperative hospital stay was 3.7 days for group TS and 6.2 days for group TT (p < 0.0001). Overall survival rates at 1, 3, and 5 years were, respectively, 87.4%, 70.9%, and 52.5% in group TS, and 82.3%, 63.6%, and 34% in group TT (p = 0.20). Disease-free survival rates at 1 and 3 years were, respectively, 50.5% and 26.4% in group TS and 60% and 24.8% in group TT (p = 0.74). Local recurrence occurred in 1 patient in each group. Survival without a homolateral recurrence (i.e., in the operated lung) at 1 and 3 years was 66.7% and 44.4% in group TS and 83.5% and 45% in group TT, respectively (p = 0.54). CONCLUSIONS: In selected patients with a maximum of two pulmonary nodules, thoracoscopic resections yield survival rates similar to open resections while being less invasive and preserving the patient's ability to undergo possible repeat operations. SN - 1552-6259 UR - https://www.unboundmedicine.com/medline/citation/19101304/Resection_of_pulmonary_metastases_from_sarcoma:_can_some_patients_benefit_from_a_less_invasive_approach L2 - https://linkinghub.elsevier.com/retrieve/pii/S0003-4975(08)02032-8 DB - PRIME DP - Unbound Medicine ER -