EJCTS Click here to go to Edwards website
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Alain Jean Poncelet
Philippe Noirhomme
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Poncelet, A. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Poncelet, A. J.
Related Collections
Right arrow Lung - cancer
Right arrow Mediastinum
Right arrow Chest wall

Eur J Cardiothorac Surg 2007;31:173-180. doi:10.1016/j.ejcts.2006.11.007
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Prognostic factors for long-term survival in patients with thoracic metastatic disease: a 10-year experience

Alain Jean Ponceleta,*, Antoine Lurquina, Birgit Weynandb, Yves Humbletc, Philippe Noirhommea on behalf of the ‘Groupe d’ Oncologie Thoracique Des Cliniques Saint-Luc’

a Department of Cardio-Vascular and Thoracic Surgery, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
b Department of Pathology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
c Department of Oncology, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium

Received 16 August 2006; received in revised form 31 October 2006; accepted 7 November 2006.

* Corresponding author. Address: Cardio-Vascular and Thoracic Surgery Unit, Cliniques universitaires St-Luc, Université catholique de Louvain, Avenue Hippocrate 10, B-1200 Brussels, Belgium. Tel.: +32 2 764 61 07; fax: +32 2 764 89 60. (Email: Poncelet{at}chir.ucl.ac.be).

Objective: To compare survival results after resection in patients with thoracic parenchymal metastatic disease versus non-parenchymal metastatic disease and to identify prognostic factors for survival. Methods: From 1990 to 2002, we retrospectively studied 134 procedures performed on 93 patients (3–84 years old). There were 73 patients with parenchymal resection and 20 patients with non-parenchymal resection. Tumor histology was epithelial in 62 patients, sarcoma in 21 patients, and teratomas and melanoma in 6 and 4 patients, respectively. Sixty-five patients underwent a metastasectomy once, whereas 28 had their metastatic disease repeatedly resected. Results: Follow-up was 100% complete with a mean time of 43 months (range 1–169). In-hospital mortality was 2.2% (3/134 procedures) and major morbidity 5.5%. Median survival was 39 months (95% CI: 21–56 months). Overall, the actuarial survival at 1, 3, and 5 years were 84%, 55%, and 44%, respectively. For the entire group, by univariate analysis, among the 13 predictor variables selected, only the number of metastases (Hazard Ratio (HR) = 3.4 [95% CI: 1.9–6.1]) and completeness of resection (HR = 2.3 [95% CI: 1.3–4.2]) were found to be significant for death whereas repeated metastasectomy was found to be a significant predictor for survival (HR = 0.25 [95% CI: 0.12–0.55]). In the group of parenchymal metastatic disease, a size greater than 3 cm was a predictor for death (HR = 2 [95% CI: 1.1–3.7]). In the subgroup of patients with colorectal metastasis, bilateral disease was also found to be a significant predictor for death (HR = 3.6, [95% CI: 1.2–11.1]). Conclusion: This study supports our current aggressive approach to metastatic thoracic disease. Indeed, patient's survival is improved while a low mortality and morbidity is achieved. The most beneficial impact on long-term survival is correlated to the completeness of the surgery whereas the increasing number and size of the metastasis inversely correlate with survival.

Key Words: Chest wall • Lung • Cancer • Mediastinum




This article has been cited by other articles:


Home page
 Ann OncolHome page
J. S. Park, H. K. Kim, Y. S. Choi, K. Kim, Y. M. Shim, J. Jo, W.-Y. Lee, H.-K. Chun, Y. S. Park, W. K. Kang, et al.
Outcomes after repeated resection for recurrent pulmonary metastases from colorectal cancer
Ann. Onc., October 27, 2009; (2009) mdp475v1.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
S. H. Blackmon, N. Shah, J. A. Roth, A. M. Correa, A. A. Vaporciyan, D. C. Rice, W. Hofstetter, G. L. Walsh, R. Benjamin, R. Pollock, et al.
Resection of pulmonary and extrapulmonary sarcomatous metastases is associated with long-term survival.
Ann. Thorac. Surg., September 1, 2009; 88(3): 877 - 884.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
B. A. Whitson, S. S. Groth, R. S. Andrade, L. Garrett, A. Z. Dudek, J. Jessurun, and M. A. Maddaus
Extension of survival by resection of asynchronous renal cell carcinoma metastases to mediastinal lymph nodes.
J. Thorac. Cardiovasc. Surg., May 1, 2008; 135(5): 1022 - 1028.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.