The Influence of the Primary Tumor on the Long-term Results of Pulmonary Metastasectomy for Metastatic Renal Cell Carcinoma
OBJECTIVE To investigate one of the primary tumor (PT) on pulmonary metastasectomy (PM) for metastatic renal cell carcinoma (RCC) and to define prognostic factors. METHODS Retrospective review of patients with pulmonary metastases from RCC from January 1999 through December 2008 was performed. All patients underwent PM with curative intend. TNM-classification, tumor stage and PT grade, disease-free-interval (DFI) from nephrectomy to the diagnosis of metastasis, systemic chemotherapy before surgical intervention, surgical procedures, morbidity, mortality, and survival were investigated. RESULTS One-hundred seven consecutive patients (age 61.5 ± 9.6 years) underwent PM. Morbidity and mortalit…
Metastasectomy With Standardized Lymph Node Dissection for Metastatic Renal Cell Carcinoma: An 11-Year Single-Center Experience
Background Pulmonary metastasectomy (PM) for metastatic renal cell carcinoma is an established method of treatment for selected patients. The incidence of intrathoracic lymph node metastases (ITLNM) and outcomes remain controversial. The purpose of this study was to determine the incidence of ITLNM and long-term outcome of PM for metastatic kidney cancer. Methods From January 1999 to December 2009, 116 patients (82 men, age 61.7 ± 9.0 years) with metastases from kidney cancer underwent PM and systematic lymph node dissection with curative intent. Kaplan-Meier analyses, log-rank test, and Cox regression analyses were used to estimate survival and to determine prognosticators of survival. Res…
Thoracic shaping technique to avoid residual space after extended pleurectomy/decortication
Extended pleurectomy/decortication or radical pleurectomy is defined as a lung-sparing surgical procedure for malignant pleural mesothelioma. A significant size mismatch between the thoracic cavity and the reduced size of the remaining lung might occur as a result of multiple resections at different sites and lead to residual thoracic space. Residual thoracic space and significant air leakage might result in postoperative complications. A simple technique of diaphragm reconstruction to avoid the residual thoracic space and to reduce the incidence of postoperative complications is described.
Radical pleurectomy and chemoradiation for malignant pleural mesothelioma: The outcome of incomplete resections
The type of surgery (radical pleurectomy (RP) vs. extrapleural pneumonectomy (EPP)) remains controversial for malignant pleural mesothelioma (MPM). Macroscopic complete resection (MCR) is a key prognostic factor. It is unclear, if patients undergoing incomplete RP within a standardized multimodality treatment protocols have any advantage in terms of survival and if EPP could theoretically have avoided incomplete resections (R2).Eighty-eight patients underwent RP followed by chemoradiation from 2002 to 2011 within a prospective multimodality treatment study at a single institution. MCR were compared to R2 within this patient cohort retrospectively. EPP eligibility was assessed retrospectivel…
The Pseudo-variable Extrathoracic Obstruction Flow Volume Loop Pattern In Double Lung And Heart Lung Transplantation
Risk factors for lymph node metastases and prognosticators of survival in patients undergoing pulmonary metastasectomy for colorectal cancer.
Background Systematic lymph node dissection is not routinely performed in patients undergoing pulmonary metastasectomy (PM) of colorectal cancer. The aim of the study was to identify risk factors for lymph node metastases (LNM) and to determine prognosticators for survival in colorectal cancer patients with pulmonary metastases. Methods We retrospectively reviewed our prospective database of 165 patients with colorectal cancer undergoing PM and systematic lymph node dissection with curative intent from 1999 to 2009. The χ 2 test, regression analyses, Kaplan-Meier analyses, log rank tests, and Cox regression analyses were used to determine prognosticators for LNM and survival. Results The pr…
Factors predicting poor survival after lung-sparing radical pleurectomy of IMIG stage III malignant pleural mesothelioma.
OBJECTIVES: The role of radical pleurectomy (RP) in the management of IMIG stage III in malignant pleural mesothelioma (MPM) remains controversial. The aim of the study was to investigate the feasibility and outcome as well as to determine factors predicting poor survival. METHODS: Patients having IMIG stage III MPM were identified within a prospective multimodality treatment study (RP followed by chemoradiation) between 2002 and 2010 at a single institution. Kaplan–Meier analyses, log-rank test and Cox regression analyses were used to estimate survival and to determine predictors of survival. RESULTS: A total of 78 patients (66.3 ± 2.5 years, 65 males) underwent RP followed by chemoradiati…
Prospective Study on Functional Results After Lung-Sparing Radical Pleurectomy in the Management of Malignant Pleural Mesothelioma
Introduction:Malignant pleural mesothelioma (MPM) can reduce lung function by entrapping lung parenchyma via a rind of tumor with or without concurrent effusion. Radical pleurectomy (RP) allows expansion of the trapped lung. The purpose of this study was to investigate changes in pulmonary function and lung perfusion in patients undergoing RP.Methods:In a prospective, nonrandomized study, all patients with histologically proven MPM were evaluated from January to December 2010 for trimodality therapy including RP as surgical procedure. Pulmonary-function tests and perfusion scans were obtained before and 2 months after RP. Primary end points were pulmonary function (forced vital capacity [FV…