Factors influencing the effect of surgical treatment in secondary proliferative disease with lung involvement

Abstract

Introduction: Surgical treatment of neoplastic lung metastases is a big therapeutic problem, at the stage of qualifying for the procedure, in the surgical technique itself, and in the tactics of managing subsequent disease relapses. The most doubtful aspect is determining which factors influence the prolongation of survival in patients with such a diagnosis. Aim: To determine which factors influence the effectiveness of surgical treatment of neoplastic metastases to the lungs. Material and methods: A group of 577 patients was subjected to the study. An analysis of all performed operations (1009) was also carried out according to the set goals. Statistical analysis was performed using the estimates of the c 2 test, Kaplan-Meier estimator, and log-rank test. Results: It was established what statistically significant factors may improve the treatment effectiveness. It was found that the lack of radicalism was influenced by: the number of lung metastases, the presence of changes in the lymph nodes, age, histology of the primary tumor and its location, and the number of treatments. Nodal metastases are more common in non-radical procedures, depend on the patient's age, are more often found in unilateral procedures, and depend on the location and histology of the primary tumor. Conclusions: It was found that the radical nature of the procedure did not affect the progression of the disease, but it did have an impact on survival. Relapses are more common in bilateral procedures, reducing survival. Lymph node metastases worsen the prognosis.

The usefulness of progression-free survival in surgical treatment of lung metastases

“…In our research, the rate was around 7%, of which around 30% were not related to the surgery. The risk of perioperative death in the study group was 0.5% [ 3 , 4 ]. For the purposes of the present study, the PFS time was defined as the appearance of new lung lesions after metastasectomy or the date of death or the date of completion of the observation assuming that the patient was alive up to that date.…”

“…Here, too, often erroneous results of publications dealing with this problem are produced. In our previous studies, after creating two comparable groups of patients, we found longer survival in patients without relapse after metastasectomy (median survival 71 months without relapse versus 36 months with relapse) [ 3 , 4 ]. Subsequent metastasectomies are directly related to disease progression.…”