Pulmonary Metastasectomy Secondary to Esophageal Carcinoma: Long-Term Survival and Prognostic Factors

Kobayashi, Nao; Kohno, Tadasu; Haruta, Shusuke; Fujimori, Sakashi; Shinohara, Hisashi; Ueno, Masaki; Udagawa, Harushi

doi:10.1245/s10434-014-3677-7

Cited by 47 publications

(33 citation statements)

References 11 publications

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“…The cumulative survival for patients without a history of extrapulmonary metastasis between initial treatment and pulmonal recurrence was 40.7% at 5 years, while the patients with well and moderately differentiated SCC had significantly prolonged survival compared to those with poor differentiated primaries ( p < 0.01). DFI of > 12 months was showed as another favorable prognostic factor (median survival with DFI > 12 months and DFI < 12 months was 43.7 and 24.7 months, respectively, p = 0.02) [ 18 ]. The largest published series is the one reported by Shiono et al, including 49 patients who underwent metastasectomy (48 cases with SCC, 1 case with adenocarcinoma), 39 of whom with solitary metastases.…”

Section: Resultsmentioning

confidence: 99%

“…As discussed before, short DFI is negatively correlated with survival [ 20 ], and long DFI is considered as a favorable prognostic factor for overall survival of both surgical and non-surgical groups [ 7 ]. Kobayashi et al and Shiono et al suggested a DFI > 12 months as a statistically significant favorable prognostic factor for pulmonary metastasectomy ( p < 0.05) [ 18 , 19 ]. With regard to pulmonary recurrence, long DFI is noted to be a favorable prognostic factor from the International Registry of Lung Metastases, but many different tumor types have been assessed in this study [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

“…The predominant histologic type of the cases mentioned above is the squamous cell carcinoma whereas the adenocarcinoma represents only a small percentage of all cases. Regarding the histological differentiation, only one study revealed poor differentiation as a prognostic factor influencing prognosis in patients undergoing pulmonary metastasectomy [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

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The role of surgical treatment in isolated organ recurrence of esophageal cancer—a systematic review of the literature

et al. 2018

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BackgroundDespite the improvements in the early detection and treatment of non-metastatic esophageal cancer, more than half of patients undergoing a curative treatment for esophageal cancer will develop recurrence within three years. The prognosis of these patients is poor. However, a wide range in overall survival has been reported, depending on the pattern of recurrence, and no optimal treatment strategy following recurrence has yet been uniformly accepted.AimIn this article, we aimed to systematically review the literature for the role of surgical resection of metachronous distant metastasis following primary treatment of esophageal cancer. Furthermore, we discuss possible factors that could possibly predict which patients may benefit from a surgical approach. A comprehensive literature search was conducted in PubMed using combinations of keywords.ResultsPatients with recurrence may benefit of a multimodality treatment. Regarding the isolated recurrence of esophageal cancer in solid visceral organs, operative intervention has been proposed as a treatment that may offer a survival benefit in an individual basis. No definitive conclusions regarding the potential survival advantage offered by the surgical treatment of solitary recurrent lesions can be drawn. However, recent improvements in surgical treatment and optimization of perioperative management guarantee an acceptable operative risk, making surgical resection of solitary recurrence lesions a considerable therapeutic option.ConclusionsIt can be conferred from the available studies that the surgical treatment of isolated recurrence from esophageal cancer may offer a survival benefit for properly selected patients. Prospective, multicenter studies might be useful to gain a better insight into those factors that affect selection of patients to take benefit from an operative intervention.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The role of surgical treatment in isolated organ recurrence of esophageal cancer—a systematic review of the literature

et al. 2018

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“…Shiono et al [7] reported a 5-year OS rate of 30 % and that the survival of patients with DFI <12 months was significantly lower than in patients with DFI >12 months. Kobayashi et al [11] also recently reported that extrapulmonary metastasis before pulmonary metastasectomy, poor differentiation of primary esophageal cancer, and short DFI are unfavorable prognostic factors. Furthermore, Takemura et al [10] showed that surgical intervention for metachronous pulmonary metastasis is an acceptable treatment option in selected patients without extrapulmonary metastasis.…”

Section: Discussionmentioning

confidence: 95%

“…Although the most common sites of distant hematogenous metastasis are the lung, liver, bone, and brain, there have been several studies on therapies for pulmonary metastasis after curative resection of esophageal cancer [6][7][8][9][10][11]. In the current study, we focused on the role of resecting metachronous pulmonary metastases of thoracic esophageal cancer at a single institution.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary metastasectomy for metachronous metastasis of esophageal cancer after esophagectomy

et al. 2015

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Cost-effectiveness of Laparoscopic vs Open Gastrectomy for Gastric Cancer

et al. 2023

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ImportanceLaparoscopic gastrectomy is rapidly being adopted worldwide as an alternative to open gastrectomy to treat gastric cancer. However, laparoscopic gastrectomy might be more expensive as a result of longer operating times and more expensive surgical materials. To date, the cost-effectiveness of both procedures has not been prospectively evaluated in a randomized clinical trial.ObjectiveTo evaluate the cost-effectiveness of laparoscopic compared with open gastrectomy.Design, Setting, and ParticipantsIn this multicenter randomized clinical trial of patients undergoing total or distal gastrectomy in 10 Dutch tertiary referral centers, cost-effectiveness data were collected alongside a multicenter randomized clinical trial on laparoscopic vs open gastrectomy for resectable gastric adenocarcinoma (cT1-4aN0-3bM0). A modified societal perspective and 1-year time horizon were used. Costs were calculated on the individual patient level by using hospital registry data and medical consumption and productivity loss questionnaires. The unit costs of laparoscopic and open gastrectomy were calculated bottom-up. Quality-adjusted life-years (QALYs) were calculated with the EuroQol 5-dimension questionnaire, in which a value of 0 indicates death and 1 indicates perfect health. Missing questionnaire data were imputed with multiple imputation. Bootstrapping was performed to estimate the uncertainty surrounding the cost-effectiveness. The study was conducted from March 17, 2015, to August 20, 2018. Data analyses were performed between September 1, 2020, and November 17, 2021.InterventionsLaparoscopic vs open gastrectomy.Main Outcomes and MeasuresEvaluations in this cost-effectiveness analysis included total costs and QALYs.ResultsBetween 2015 and 2018, 227 patients were included. Mean (SD) age was 67.5 (11.7) years, and 140 were male (61.7%). Unit costs for initial surgery were calculated to be €8124 (US $8087) for laparoscopic total gastrectomy, €7353 (US $7320) for laparoscopic distal gastrectomy, €6584 (US $6554) for open total gastrectomy, and €5893 (US $5866) for open distal gastrectomy. Mean total costs after 1-year follow-up were €26 084 (US $25 965) in the laparoscopic group and €25 332 (US $25 216) in the open group (difference, €752 [US $749; 3.0%]). Mean (SD) QALY contributions during 1 year were 0.665 (0.298) in the laparoscopic group and 0.686 (0.288) in the open group (difference, −0.021). Bootstrapping showed that these differences between treatment groups were relatively small compared with the uncertainty of the analysis.Conclusions and RelevanceAlthough the laparoscopic gastrectomy itself was more expensive, after 1-year follow-up, results suggest that differences in both total costs and effectiveness were limited between laparoscopic and open gastrectomy. These results support centers’ choosing, based on their own preference, whether to (de)implement laparoscopic gastrectomy as an alternative to open gastrectomy.

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Pulmonary Metastasectomy Secondary to Esophageal Carcinoma: Long-Term Survival and Prognostic Factors

Cited by 47 publications

References 11 publications

The role of surgical treatment in isolated organ recurrence of esophageal cancer—a systematic review of the literature

The role of surgical treatment in isolated organ recurrence of esophageal cancer—a systematic review of the literature

Pulmonary metastasectomy for metachronous metastasis of esophageal cancer after esophagectomy

Cost-effectiveness of Laparoscopic vs Open Gastrectomy for Gastric Cancer

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