Outcome of Repeated Resection of Pulmonary Metastases for Renal Cell Cancer

Hassan, Mohamed; Ehle, Benjamin; Le, Uyen-Thao; Titze, Laurin; Passlick, Bernward; Grapatsas, Konstantinos

doi:10.1055/s-0042-1755555

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…However, the fear of complications should not exclude patients from a potential curative RPM. In the study of Hassan et al and in the current one, the rate of major complications was acceptable [31]. Moreover, it is believed that RPM prolongs survival, as it re-establishes a local control of the tumor disease in the lung and in this way "sets back the clock of the tumor disease" [32].…”

Section: Discussionmentioning

confidence: 63%

New Prognostic Score (Essen Score) to Predict Postoperative Morbidity after Resection of Lung Metastases

Grapatsas,

Dörr,

Menghesha

et al. 2023

Cancers

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Background: Pulmonary metastasectomy (PM) is a widely accepted surgical procedure. This study aims to investigate postoperative morbidity and mortality after PM and develop a score to predict high-risk patients. Methods: We retrospectively investigated all patients undergoing a PM in our institution from November 2012 to January 2023. Complications were defined as the diagnosis of any new disease after the PM up to 30 days after the operation. Results: 1284 patients were identified. At least one complication occurred in 145 patients (11.29%). Only one patient died during the hospital stay. Preoperative cardiovascular comorbidities (OR: 2.99, 95% CI: 1.412–3.744, p = 0.01), major lung resections (OR: 2.727, 95% CI: 1.678–4.431, p < 0.01), repeated pulmonary metastasectomy (OR: 1.759, 95% CI: 1.040–2.976, p = 0.03) and open thoracotomy (OR: 0.621, 95% CI: 0.415–0.930, p = 0.02) were identified as independent factors for postoperative complications. Based on the above independent factors for postoperative morbidity, the Essen score was developed (overall correct classification: 94.6%, ROC-Analysis: 0.828, 95% CI: 0.795–0.903). Conclusion: PM is a safe surgical procedure with acceptable morbidity and low mortality. The aim of the Essen score is to identify patients that are associated with risk for postoperative complications after PM.

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Section: Discussionmentioning

confidence: 63%

New Prognostic Score (Essen Score) to Predict Postoperative Morbidity after Resection of Lung Metastases

Grapatsas,

Dörr,

Menghesha

et al. 2023

Cancers

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“…Older patients generally have poor cardiopulmonary reserve and are more comorbid than younger ones. For this reason, elderly patients with non-small cell lung cancer (NSCLC) are usually undertreated or treated conservatively only because of their age [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, improvements in video-assisted thoracic surgery (VATS) such as uniportal VATS and non-intubated VATS, as well as preoperative tumor localization (e.g., with the placement of wires preoperatively), have extended indications and possibilities for thoracic surgical resections, even for elderly patients. However, open lung resections are still performed whenever it is indicated [ 4 , 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Are Extensive Open Lung Resections for Elderly Patients with Lung Cancer Justified?

et al. 2023

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Background: Older patients with malignancies are more comorbid than younger ones and are usually undertreated only because of their age. The aim of this study is to investigate the safety of open anatomical lung resections for lung cancer in elderly patients. Methods: We retrospectively analyzed all patients who underwent lung resection for lung cancer in our institution and categorized them into two groups: the elderly group (≥70 years old) and the control (<70). Results: In total, 135 patients were included in the elderly group and 375 in the control. Elderly patients were more frequently diagnosed with squamous cell carcinoma (59.3% vs. 51.5%, p = 0.037), higher differentiated tumors (12.6% vs. 6.4%, p = 0.014), and at an earlier stage (stage I: 55.6% for elderly vs. 36.6%, p = 0.002). Elderly patients were more vulnerable to postoperative pneumonia (3.7% vs. 0.8%, p = 0.034), lung atelectasis (7.4% vs. 2.9%, p = 0.040), and pleural empyema (3.2% vs. 0%, p = 0.042), however, with no increased 30-day-mortality (5.2% for elderly vs. 2.7%, p = 0.168). Survival was comparable in both groups (43.4 vs. 45.3 months, p = 0.579). Conclusions: Elderly patients should not be excluded from open major lung resections as the survival benefit is not reduced in selected patients.

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Recurrences and Subsequent Treatments After Curative-Intent Surgery for Localised and Locally Advanced Renal Cell Carcinoma

Petersson,

Niebuhr,

Jensen

et al. 2024

Ann Surg Oncol

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Background There is a lack of evidence concerning recurrent patterns and treatment of repeat recurrences for surgically treated renal cell carcinoma (RCC). Thus, the objective was to describe patterns of recurrences and subsequent treatments in patients with recurrent RCC. Patients and Methods We identified 525 patients who received surgical treatment for RCC at our institution in 2010–2015. The treatment of recurrences was classified as no active treatment, treatment with the aim to achieve no evidence of disease (NED) or systemic oncological treatment (OT). Relationships were analysed using multivariable Cox regression and log-rank analysis. Results The median follow-up was 7.8 [interquartile range (IQR 6.5–9.4)] years. Ninety-one patients experienced a first recurrence, of which 49 received NED-aimed treatment—47 of these patients had their recurrence more than 2 years after surgery. Thirty patients experienced a second recurrence with 17 patients undergoing NED-aimed treatment. Eight patients had a third recurrence with four undergoing NED-aimed treatment. The most common locations of recurrence were pulmonary, local or multiple sites—30% and 38% of patients experienced a second or third recurrence in the same location, respectively. The 3-year overall survival estimates for patients receiving NED-aimed treatment for their first recurrence were 83.1% [95% confidence interval (CI) 72.3–93.8%] and 79.3% (95% CI 58.4–100%) for patients receiving NED following a second recurrence. Conclusions Treatments aimed at achieving NED seem to provide good oncological control and in repeat recurrences, 50% or more were managed with repeat NED-aimed treatments.

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Outcome of Repeated Resection of Pulmonary Metastases for Renal Cell Cancer

Cited by 3 publications

References 23 publications

New Prognostic Score (Essen Score) to Predict Postoperative Morbidity after Resection of Lung Metastases

New Prognostic Score (Essen Score) to Predict Postoperative Morbidity after Resection of Lung Metastases

Are Extensive Open Lung Resections for Elderly Patients with Lung Cancer Justified?

Recurrences and Subsequent Treatments After Curative-Intent Surgery for Localised and Locally Advanced Renal Cell Carcinoma

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