The surgical management of pulmonary metastasis: current concepts

Davidson, Robert S.; Nwogu, Chukwumere; Brentjens, Mathijs; Anderson, Timothy

doi:10.1016/s0960-7404(01)00013-5

Cited by 104 publications

(65 citation statements)

References 25 publications

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“…Lung metastases have been found in 25-30% of the patients with malignant tumors at autopsy [8]. The incidence of lung metastases was especially high, up to 41.6-43.6%, in hepatocellular carcinoma [4,5].…”

Section: Discussionmentioning

confidence: 99%

“…This high survival rate was due to the patients selected only with a solitary pulmonary metastasis and no concomitant intrahepatic recurrence after hepatectomy for HCC. Davidson et al [8] summarized the established criteria for the surgical management of pulmonary metastases which were limited and strict. But most pulmonary metastases of HCC were multiple and were not amenable to surgical resection.…”

Section: Discussionmentioning

confidence: 99%

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Prognostic analysis of pulmonary metastases from hepatocellular carcinoma

et al. 2008

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Purpose To analyze the prognostic factors for the patients with lung metastases from hepatocellular carcinoma (HCC). Methods and materials One hundred and five patients with lung metastases from HCC were analyzed retrospectively. We analyzed the impact factors, including the gender, age, liver function, serum AFP and c-GT level, the status of intrahepatic tumor and pulmonary metastases and treatment for them, the distant metastases beyond the lung, as well as the causes of death. The overall cumulative probability of survival was calculated by the Kaplan-Meier method, and the difference between the groups was compared using the Log-rank test. Univariate and multivariate analyses using the Cox-regression proportional hazard model were performed to evaluate the prognostic parameters for survival. Result The survival after the lung metastases was influenced by clinical parameters, such as the status and the treatment for both the intrahepatic tumor and the pulmonary lesions. The causes of death were respiratory failure due to metastatic lesions from HCC in 16 patients (20.0%), liver failure caused by the progressive intrahepatic lesions in 54 (67.5%). The mean and median survival times were 684 and 487 days after HCC diagnosis and 264 and 179 days after lung metastases, respectively. Conclusion It was very important to treat the intrahepatic tumor because its worsening was still the major cause of death. The progressive treatment for pulmonary metastases may also be advised for possible prolongation of survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prognostic analysis of pulmonary metastases from hepatocellular carcinoma

et al. 2008

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“…Reportedly, 40-50% of all patients who undergo curative surgery for colorectal cancer will ultimately develop recurrence and die (1,2). Following the liver, the lung is the second most common site of distant metastasis (1-3): lung metastases occur in 10-20% of patients (3).…”

Section: Introductionmentioning

confidence: 99%

Long-term results of radiofrequency ablation in colorectal lung metastases: Single center experience

Yamakado

Inoue²,

Takao³

et al. 2009

Oncol Rep

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Abstract. This study was undertaken to evaluate long-term results of radiofrequency (RF) ablation in patients with colorectal lung metastases and to stratify patients benefitting from lung RF ablation. Lung RF ablation was performed in 78 patients with 198 colorectal lung metastases. Safety, local tumor progression, and survival were evaluated retrospectively. The mean follow-up period after the 140 lung RF ablation sessions was 24.6±7.6 months. Pneumothorax and pleural effusion requiring chest tube placement occurred respectively in 18 (12.9%, 18/140) and 2 (1.4%, 2/140) sessions. The respective 1-, 3-and 5-year local tumor progression rates were 10.1% (95% CI, 2.9-17.3%), 20.6% (95% CI, 8.9-22.2%) and 20.6% (95% CI, 8.9-22.2%). The 1-, 3-and 5-year survival rates were 83.9% (95% CI, 75.2-92.7%), 56.1% (95% CI, 41.7-70.5%) and 34.9% (95% CI, 18.0-51.9%), with median survival time of 38.0 months. Univariate analysis revealed maximum tumor diameter of 3 cm or less, single-lung metastasis, lack of extrapulmonary metastasis and normal carcinoembryonic antigen (CEA) level as better prognostic factors. The latter two were significant independent prognostic factors. The 1-, 3-and 5-year survival rates were 97.7% (95% CI, 93.3-100%), 82.5% (95% CI, 68.2-96.8%) and 57.0% (95% CI, 34.7-79.2%) in 54 patients with no extrapulmonary metastases and 96.9% (95% CI, 90.8-100%), 86.1% (95% CI, 71.1-100%) and 62.5% (95% CI, 36.3-88.6%) in 33 patients with negative CEA levels. Lung RF ablation is a safe and useful therapeutic option. These identified prognostic factors will help to stratify patients who benefit from lung RF ablation.

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“…Two of the organs most frequently affected by cancer metastasis are the lungs, and at some stage, ~30% of all cancer patients will develop lung metastases (2). This is mainly as the lung is the first filter in the general circulation (3,4).…”

Section: Introductionmentioning

confidence: 99%

Multiple pulmonary metastases with halo‑sign from malignant mixed M?llerian tumors

Tian

Yang

et al. 2017

Oncol Lett

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Abstract. The lungs are one of the most common organs to which cancer metastasizes, but are a location not common for uterine sarcoma. A malignant mixed Müllerian tumor (MMMT) of the uterus is an extremely rare and aggressive sarcoma, characterized by a mixture of epithelial and mesenchymal components. There are few reports regarding the pulmonary metastasis from MMMTs. The present study presents the case of a 58-year-old woman with hemoptysis and post-menopausal vaginal bleeding. The woman was initially diagnosed with invasive aspergillosis based on a chest computed tomography (CT) scan showing multiple pulmonary nodular opacities surrounded by a ground-glass attenuation halo (halo-sign). Diagnostic curettage and a percutaneous CT-guided lung biopsy were conducted for the pathological diagnosis. Finally, the diagnosis was confirmed as MMMT with lung metastasis based on the histopathological examination of cervical canals, uterus and lung specimens, which showed a mixture of carcinomatous and sarcomatous elements, and morphology exhibiting hyperchromatic nuclei and necrosis. Immunohistochemical staining was positive for vimentin, focally positive for p16, and negative for napsin, cytokeratin 7 (CK7), CK20, carcinoembryonic antigen, carbohydrate antigen 125, homeobox protein CDX2 and villin in the lung specimens. This case highlights that pulmonary metastatic tumor from uterine sarcoma can present as halo-sign, which is commonly observed in pulmonary aspergillosis. Therefore, it needs to be considered in the differential diagnosis of such lesions, and pathological confirmation is required.

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The surgical management of pulmonary metastasis: current concepts

Cited by 104 publications

References 25 publications

Prognostic analysis of pulmonary metastases from hepatocellular carcinoma

Prognostic analysis of pulmonary metastases from hepatocellular carcinoma

Long-term results of radiofrequency ablation in colorectal lung metastases: Single center experience

Multiple pulmonary metastases with halo‑sign from malignant mixed M?llerian tumors

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