SATS 2009 Final Program - Scandinavian Association for Thoracic ...

S09
SATS CARDIOTHORACIC ORAL ABSTRACT SESSION
S09:1
OUTCOME AFTER PULMONARY METASTASECTOMY: ANALYSIS OF SURGICAL RESECTIONS
DURING A 5 YEAR PERIOD.
Hornbech Kåre 1 , Ravn Jesper B. 1 , Steinbrüchel Daniel A. 1
1) Rigshospitalet, Denmark
Objective
Pulmonary metastasectomy for a wide range of different primary malignancies has become a progressively accepted
treatment in patients with metastatic disease confined to the lungs. In the present single center study we analyze
the results of management of pulmonary metastases in 5 years consecutive operations. We aim to define patients
who are most likely to benefit from surgery by investigating long-term survival and prognostic factors associated
with prolonged survival in a recent study population.
Methods
The data on all consecutive patients who underwent pulmonary metastasectomy between 2002 and 2006 were
reviewed retrospectively. In total 178 patients underwent 256 surgical resections for suspected pulmonary metastases
from different primary malignancies.
Results
Complete resection was achieved in 247 cases (96.4%). 25 patients (9.7%) had benign lesions and 25 patients
(9.7%) had a primary lung cancer. 30-day morbidity and mortality were 6.6% and 1.9% respectively. Mean follow-up
was 49.5 ± 17.8 months. The 5-year survival after metastasectomy according to primary tumour was: colorectal
carcinoma 53.3%, sarcoma 20.9%, malignant melanoma 26.7%, renal cell carcinoma 38.1% and miscellaneous
primary malignancies 50.0%. Of the prognostic factors analyzed by univariate analysis none were significant in all
the different groups of cancers.
Conclusions
Pulmonary metastasectomy is a safe and effective treatment that leads to possible long-term survival in selected
patients. Low morbidity and mortality rates in contrast with the lack of any other effective oncological treatment
justify the aggressive approach of surgery. Solid prognostic factors need to be established.
S09:2
SURGICAL RESECTION OF PULMONARY METASTASES FROM COLORECTAL CARCINOMA IN ICELAND
Vidarsdottir Halla 1 , Moller Pall 1 , Jonasson Jon Gunnlaugur 1 , Gudbjartsson Tomas 1
1) Landspitali University Hospital, Iceland
Background
Over half of patients operated for colorectal cancer are later diagnosed with recurrent disease, most often
metastases in the liver or lungs. Pulmonary metastases can be removed surgically; however, the survival benefit has
been debated. The aim of this study was to study surgical outcome of pulmonary metastasectomy in a well defined
patient cohort.
Materials and methods
All patients that underwent complete pulmonary resection of metastatic colorectal carcinoma from 1984-2008.
Average follow up was 41 months.
Results
Altogether 32 procedures on 27 patients were performed (age 63.5 yrs, range 35-80, 63% males). 19 with colon
(70%) and 8 with rectal cancer (30%).The disease-free-interval was 29 months (range, 0-74) and 5 patients had
undergone prior metastasectomy of the liver. Pre-thoracotomy CEA level was elevated in 9 of the patients. Eighteen
patients had a solitary and 6 had two pulmonary nodules, other patients having multiple nodules. Lobectomy (n=18)
and wedge resection (n=14) were the most common procedures. Three patients were operated for bilateral and 3
for recurrent pulmonary metastases. All patients survived surgery and median length of hospital stay was 8 days
(range, 5-58). Air leakage (19%) and pneumothorax (26%) were the most common complications. One and 5 year
survival was 92.3 and 30.4%, respectively.
Conclusion
Surgical outcome in this series was good with low morbidity and mortality. The 5 year survival was 30.4 %, a much
improved survival compared to patients with metastatic disease in general (