Thoracic Lymphatic Involvement in Patients Having Pulmonary Metastasectomy: Incidence and the Effect on Prognosis

Garcı́a-Yuste, Mariano; Cassivi, Stephen D.; Paleru, Cristian

doi:10.1097/jto.0b013e3181dcf920

Cited by 52 publications

(29 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…According to some studies an improvement in long-term survival is also possible, e.g. in patients with preoperatively unidentifi ed affl iction of mediastinal lymphatic nodes which may be up to 14% according to Loehe (3,16,27,32). In our group, the tumor infi ltration in regional lymphatic nodes was not preoperatively expected in any of our 8 patients (9.2 % of the whole group, 15.4 % of the performed collections).…”

Section: Discussionmentioning

confidence: 72%

“…The frequency of affl iction of hilar and mediastinal lymphatic nodes by dissemination of cancer is described within a range of 8 to 33 % in pulmonary metastases with a demonstrably worse survival (27,30,31,32). The benefi t of SMLA in pulmonary metastasectomy is currently under investigation, nevertheless it is largely recommended.…”

Section: Discussionmentioning

confidence: 99%

“…The benefi t of SMLA in pulmonary metastasectomy is currently under investigation, nevertheless it is largely recommended. It is mainly because of the improvement in staging and choice of adjuvant oncological therapy (30,32). According to some studies an improvement in long-term survival is also possible, e.g.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Surgical therapy of pulmonary metastases – 10-year results

Vodička¹,

Spidlen²,

Šimánek³

et al. 2013

BLL

View full text Add to dashboard Cite

Introduction:The surgical therapy of selected secondary pulmonary tumors, including both solitary and multiple or bilateral tumours, is currently a generally accepted therapeutic procedure demonstrably extending the long term survival of these patients. Purpose: The purpose of the present study is a ten-year retrospective analysis of a group of patients who underwent surgery due to pulmonary metastases of various primary tumors. Methods: In 2000-2009, 87 patients (of which 44 were male with a median age of 64 years) with secondary pulmonary tumors underwent surgery at the departments of the authors of this study. Solitary metastases were found in 60 patients, multiple metastases in the remaining patients, while 13 patients had bilateral metastases. The median disease-free period from surgery of the primary tumor was 31 months. Results: In total, 74 unilateral and 13 bilateral surgeries were performed in one or two periods. The most common type of surgery included anatomical pulmonary resections (32 procedures), wedge resections (29 procedures) and laser excisions (24 procedures). In total, the radical resection was performed in 156 metastases. Post-operative morbidity was 17.2 % with zero mortality. A proportion of 50.6 % of operated patients survived after resection of metastases with median survival of 39 months. The overall three-year and fi ve-year survivals in the group were 57 % and 38 %, respectively. A proportion of 35.6 % of patients live after resection of metastases without disease progression, and the median is 15 months. Conclusion:The achieved results confi rm the positive role of pulmonary metastasectomy in the therapy of disseminated cancer disease (Tab. 1, Fig. 5, Ref. 34 Hematogeneous pulmonary metastases are generally considered as a sign of advanced generalization of malignant disease. Up to one third of malignant tumors have pulmonary metastases, and in most of them the lungs are even the fi rst site of dissemination. Nevertheless, in a signifi cant number of patients, the pulmonary affl iction is stopped or eliminated during the dissemination of metastases, and these patients may benefi t from radical resection of metastases (1, 2). Surgical therapy of the selected secondary pulmonary tumors, not only solitary but also multiple or bilateral, is today generally the accepted therapeutic procedure which demonstrably extends long term survival of these patients with acceptable peri-operative morbidity and mortality. The purpose of the following study is a retrospective analysis of a group of patients who underwent surgery due to pulmonary metastases of various primary tumors over a period of ten years. Material and methodsIn 2000-2009 we performed surgery on 87 patients with secondary pulmonary tumors. Only patients who had undergone a radical resection of the primary tumor, were free from other extrapulmonary metastases, their pulmonary metastases appeared to be radically removable according to the pre-operative examinations as for the number and location, and the benefi t of surgery...

show abstract

Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Surgical therapy of pulmonary metastases – 10-year results

Vodička¹,

Spidlen²,

Šimánek³

et al. 2013

BLL

View full text Add to dashboard Cite

show abstract

“…Actuellement, la place du curage ganglionnaire pour les métastases de cancers colorectaux tend à se généraliser et devient de moins en moins controversée dans cette indication. Durant ces 15 dernières années, trois grandes méta-analyses ont été rapportées sur la prise en charge chirurgicale des métastases pulmonaires, notamment liées au cancer colorectal [1,[32][33][34][35].…”

Section: Place Du Curage Ganglionnaireunclassified

Exérèse chirurgicale des métastases pulmonaires de cancer colorectal : quelle stratégie en 2014 ?

Latour¹,

Guihaire²,

Van³

et al. 2014

Oncologie

View full text Add to dashboard Cite

La résection pulmonaire en cas de cancer colorectal métastatique est possible si la maladie est stable et sous contrôle. Les patients sont admissibles après une évaluation stricte et une longue période de rémission. Nous avons effectué une revue de la littérature récente portant sur la résection pulmonaire en cas de cancer colorectal métastatique en comparant particulièrement le rôle de la chirurgie conventionnelle face à la thoracotomie et à la vidéothoracoscopie. La survie à cinq ans de ces patients varie entre 35 et 61,4 % selon les séries. La chirurgie vidéothoracoscopique permet une résection complète de la maladie (R0), mais seule la chirurgie conventionnelle semble offrir un bon curage ganglionnaire. Il est établi que la vidéothoracoscopie peut être une alternative pour les patients fragiles et difficilement opé-rables. La chirurgie ouverte reste aujourd'hui la référence ; cependant, et à notre connaissance, elle est controversée, car il n'existe pas d'études randomisées solides pour démontrer son efficacité. La chirurgie est plus susceptible de détecter une petite tumeur via palpation bidigitale du reste du poumon. Elle reste aujourd'hui la meilleure stratégie possible pour les patients atteints de cancers métastatiques dont la fonction pulmonaire permet une résection du poumon. Dans ce contexte, la médiastinoscopie garde clairement une place prépondérante dans la stratégie thérapeutique, car elle définit le staging ganglionnaire. L'ablation par radiofréquence (RF) et la radiothérapie stéréotaxique ablative sont aussi des alternatives appropriées pour le contrôle local. Pour les patients fragiles, elles représentent une thérapeutique acceptable.Mots clés Colorectal métastatique · Vidéothoracoscopie · Chirurgie conventionnelle · Médiastinoscopie · Ablation par radiofréquence · Radiothérapie stéréotaxique ablative Abstract Pulmonary resection of metastatic colorectal cancer is reasonable if the disease is stable and hallmark. Patients are eligible after highly selected assessment and long disease-free interval. We reviewed the recent literature about pulmonary resection of metastatic colorectal cancer, especially comparing the role of conventional surgery through thoracotomy with videothoracoscopy. The survival (5 years) rate of these patients ranges from 35 to 61.4% depending on the series. Videothoracic surgery allows a complete resection of the disease (R0); however, only conventional surgery seems to provide good lymphatic nodes removal. It is well known that videothoracoscopy may be an alternative in fragile and poor condition patients. Open surgery remains today the gold standard although, and according to our knowledge, there is no solid randomized study to demonstrate so and the subject remains controversial. Surgery is more sensitive to detect small tumor through bidigital palpation of the remaining lung. It remains today the best strategy for metastatic patients with pulmonary function suitable for lung resection. In that field, mediastinoscopy clearly plays a key role in the therapeutic strategy ...

show abstract

“…The results obtained in this study were slightly higher than those reported in the literature, and this can be explained as follows: The European Society of Thoracic Surgeons suggests determining whether the patients who underwent pulmonary metastasectomy had lymph node metastases before undergoing surgery. The incidence of lymph node presence in patients undergoing pulmonary metastasectomy was approximately 20% (21). Applying mediastinoscopy to patients is unusual before performing this operation (22).…”

Section: N (%)mentioning

confidence: 99%

Efficacy of Endobronchial Ultrasound-Guided Transbronchial Needle Biopsy for the Diagnosis of Intrathoracic Lymph Node Metastases from Extrathoracic Malignancies

Öztürk¹,

Yılmaz²,

Aktaş³

et al. 2017

Eurasian J Pulmonol

View full text Add to dashboard Cite

Objective: Intrathoracic lymph node enlargement is common among patients with extrathoracic malignancies. While endobronchial ultrasound-guided-transbronchial needle aspiration (EBUS-TBNA) is often used for diagnosing mediastinal or hilar lymph nodes and for staging lung cancer, there are still a few studies demonstrating the use of EBUS-TBNA for determining intrathoracic metastases from extrathoracic malignancies. The aim of this study is to evaluate the role of EBUS-TBNA for the diagnosis of extrathoracic malignancies. Methods:From March 2010 to July 2015, 190 patients with known extrathoracic malignancy, who underwent diagnostic convex probe (CP)-EBUS-TBNA due to suspicion of metastases, were included in the study. The patients' data were retrospectively investigated. Results:The findings of EBUS-TBNA were examined; 61 patients (32%) were malignant, 121 (63%) were benign, and 3 (1.5%) were not diagnostic. Five patients (3.5%) were not sampled because of the millimetric size of the lymph nodes. There was no progression at the 12-month follow-up in these patients. Among the malignancy patients, 40 had extrathoracic malignancy-related intrathoracic metastases. The diagnosis of the lymph nodes with EBUS-TBNA and the final diagnosis at follow-up are given as summarized. The size of the lymph node decreased during clinical follow-up in one of the three non-diagnostic patients (accepted as having reactive lymph node). The other two patients were diagnosed as malignant using mediastinoscopy (having esophageal cancer and squamous cell lung cancer). The sensitivity was found to be 95.3%, specificity was 100%, the negative predictive value was 97.6%, and the diagnostic accuracy rate was 98.4%. Conclusion:EBUS-TBNA is a simple, reliable, and adequate diagnostic method for determining intrathoracic lymph node metastases related to known extrathoracic malignancies.

show abstract

Thoracic Lymphatic Involvement in Patients Having Pulmonary Metastasectomy: Incidence and the Effect on Prognosis

Cited by 52 publications

References 11 publications

Surgical therapy of pulmonary metastases – 10-year results

Surgical therapy of pulmonary metastases – 10-year results

Exérèse chirurgicale des métastases pulmonaires de cancer colorectal : quelle stratégie en 2014 ?

Efficacy of Endobronchial Ultrasound-Guided Transbronchial Needle Biopsy for the Diagnosis of Intrathoracic Lymph Node Metastases from Extrathoracic Malignancies

Contact Info

Product

Resources

About