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Evaluation of video-assisted thoracoscopic surgery for pulmonary metastases: 11-years of experience

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Abstract

Background

Although video-assisted thoracoscopic surgery (VATS) has been applied to pulmonary resection for pulmonary metastases, the clinical validity of this approach remains controversial. The purpose of this study was to evaluate the validity and problems of VATS for pulmonary metastasectomy.

Methods

From January 1993 to December 2003, VATS for pulmonary metastasectomy was performed in 53 resections for 48 patients at our institution. The medical records of these patients were retrospectively reviewed.

Results

The primary tumor was colorectal cancer in 23 patients, renal cell carcinoma in 6, breast cancer in 6, germ cell tumor in 5, head and neck cancer in 2, and others in 6. Thirty-six cases had a solitary lesion, 8 had unilateral multiple lesions, and 9 had bilateral multiple lesions. The following procedures were performed: 7 lobectomies, 5 segmentectomies, and 41 wedge resections. There was no major postoperative morbidity related to VATS. At a median follow-up period of 29.0 months, 13 patients were alive without recurrences. The 3-year overall survival rate and the 3-year intrathoracic disease-free survival rate were 59.8% and 33.4%, respectively. Five cases had recurrence at the surgical stump or at the port sites, but these recurrences have not been found in the recent period since June 1997. Intrathoracic recurrences within 3 months after VATS occurred in four.

Conclusion

VATS for pulmonary metastases is not superior to the conventional open thoracotomy and is not recommended as a standard procedure. Further studies with a larger number of cases performed by skilled surgeons familiar with VATS are needed.

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References

  1. Lin JC, Wiechmann RJ, Szwerc MF, Hazelzigg SR, Ferson PF, Naunheim KS, Keenan RJ, Yim AP, Rendina E, Giacomo TD, Coloni GF, Venuta F, Marcherey RS, Bartley S, Landreneau RJ (1999) Diagnostic and therapeutic video-assisted thoracic surgery resection of pulmonary metastases. Surgery 126:636–642

    PubMed  CAS  Google Scholar 

  2. De Giacomo T, Rendina EA, Venuta F, Ciccone AM, Coloni GF (1999) Thoracoscopic resection of solitary lung metastases from colorectal cancer is a viable therapeutic option. Chest 115:1441–1443

    Article  PubMed  Google Scholar 

  3. Landreneau RJ, Giacomo TD, Mack MJ, Hazelrigg SR, Ferson PF, Keenan RJ, Luketich JD, Yim AP, Coloni GF (2000) Therapeutic video-assisted thoracoscopic surgical resection of colorectal pulmonary metastases. Eur J Cardiothorac Surg 18:671–677

    Article  PubMed  CAS  Google Scholar 

  4. Nakajima J, Takamoto S, Tanaka M, Takechi E, Murakawa T, Fukami T (2001) Thoracoscopic surgery and conventional open thoracotomy in metastatic lung cancer. Surg Endosc 15:849–853

    Article  PubMed  CAS  Google Scholar 

  5. Mutsaerts ELAR, Zoetmulder FAN, Meijer S, Baas P, Hart AAM, Rutgers EJT (2002) Long term survival of thoracoscopic metastasectomy vs. metastasectomy by thoracotomy in patients with a solitary pulmonary lesion. Eur J Surg Oncol 28:864–868

    Article  PubMed  CAS  Google Scholar 

  6. Thomford NR, Woolner LB, Clagett OT (1965) The surgical treatment of metastatic tumors in the lungs. J Thorac Cardiovasc Surg 49:357–363

    PubMed  CAS  Google Scholar 

  7. Fry WA, Siddiqui A, Pensler JM, Mostafavi H (1995) Thoracoscopic implantation of cancer with a fatal outcome. Ann Thorac Surg 59:42–45

    Article  PubMed  CAS  Google Scholar 

  8. Downey RJ, McCormack P, LoCicero J 3rd (1996) Dissemination of malignant tumors after video-assisted thoracic surgery: a report of twenty-one cases. J Thorac Cardiovasc Surg 111:954–960

    Article  PubMed  CAS  Google Scholar 

  9. Johnstone PAS, Rohde DC, Swartz SE, Fetter JE, Wexner SD (1996) Port site recurrences after laparoscopic and thoracoscopic procedures in malignancy. J Clin Oncol 14:1950–1956

    PubMed  CAS  Google Scholar 

  10. Mutsaerts EL, Zoetmulder FA, Rutgers EJ (2001) Port site metastasis as a complication of thoracosopic metastatectomy. Eur J Surg Oncol 27:327–328

    Article  PubMed  CAS  Google Scholar 

  11. Parekh K, Rusch V, Bains M, Downey R, Ginsberg R (2001) VATS port site recurrence: a technique dependent problem. Ann Surg Oncol 8:175–178

    Article  PubMed  CAS  Google Scholar 

  12. McCormack PM, Bains MS, Begg CB, Burt ME, Downey RJ, Panicek DM, Rusch VW, Zakowski M, Ginberg RJ (1996) Role of video-assisted thoracic surgery in the treatment of pulmonary metastases: results of a prospective trial. Ann Thorac Surg 62:213–216

    Article  PubMed  CAS  Google Scholar 

  13. Ambrogi V, Paci M, Pompeo E, Mineo TC (2000) Transxiphoid video-assisted pulmonary metastasectomy: relevance of helical computed tomography occult lesions. Ann Thorac Surg 70:1847–1852

    Article  PubMed  CAS  Google Scholar 

  14. Stefano M, Venanzio P, Antonio D’A, Alfredo C, Domenico G, Giuseppe M, Pierluigi G (2002) Pulmonary metastases: can accurate radiological evaluation avoid thoracotomic approach? Eur J Cardiothorac Surg 21:1111–1114

    Article  Google Scholar 

  15. Parsons AM, Dettebeck FC, Parker LA (2004) Accuracy of helical CT in the detection of pulmonary metastases: is intraoperative palpation still necessary? Ann Thorac Surg 78:1910–1918

    Article  PubMed  Google Scholar 

  16. The International Registry of Lung Metastases, Writing Committee, Pastorino U, Buyse M, Friedel G, Ginsberg RJ, Girard P, Goldstraw P, Johnston M, McCormack P, Pass H, Putnam JB Jr (1997) Long-term result of lung metastasectomy: prognostic analyses based on 5,206 cases. J Thorac Cardiovasc Surg 113:37–49

    Article  Google Scholar 

  17. Liu D, Labow DM, Dang N, Martini N, Bains M, Burt M, Downey R Jr, Rusch V, Shah J, Ginsberg RJ (1999) Pulmonary metastasectomy for head and neck cancers. Ann Surg Oncol 6:572–578

    Article  PubMed  CAS  Google Scholar 

  18. Tsuchiya H, Kanazawa Y, Abdel-Wanis ME, Asada N, Abe S, Isu K, Sugita T, Tomita K (2002) Effect of timing of pulmonary metastases identification on prognosis of patients with osteosarcoma: The Japanese Musculoskeletal Oncology Group Study. J Clin Oncol 110:3470–3477

    Article  Google Scholar 

  19. Saito Y, Omiya H, Kohno K, Kobayashi T, Itoi K, Teramachi M, Sasaki M, Suzuki H, Takao H, Nakade M, for the Kansai Clinical Oncology Group (Japan) (2002) Pulmonary metastasectomy for 165 patients with colorectal carcinoma: a prognostic assessment. J Thorac Cardiovasc Surg 124:1007–1013

    Article  PubMed  Google Scholar 

  20. Inoue M, Ohta M, Iuchi K, Matsumura A, Ideguchi K, Yasumitsu T, Nakagawa K, Fukuhara K, Maeda H, Takeda S, Minami M, Ohno Y, Matsuda H (2004) Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 78:238–244

    Article  PubMed  Google Scholar 

  21. Rena O, Papalia E, Oliaro A, Filosso P, Ruffini E, Maggi G, Casadio C (2006) Pulmonary metastases from epithelial tumors: late results of surgical treatment. Eur J Cardiothorac Surg 30:217–222

    Article  PubMed  Google Scholar 

  22. Pastorino U, Veronesi G, Landoni C, Leon M, Picchio M, Solli PG, Leo F, Spaggiari L, Pelosi G, Bellomi M, Fazio F (2003) Fluorodeoxyglucose positron emission tomography improves preoperative staging of respectable lung metastasis. J Thorac Cardiovasc Surg 126:1906–1910

    Article  PubMed  CAS  Google Scholar 

  23. Herder GJ, Golding RP, Hoekstra OS, Comans EF, Teule GJ, Postmus PE, Smit EF (2004) The performance of 18F-fluorodeoxyglucose positron emission tomography in small solitary pulmonary nodules. Eur J Nucl Med Mol Imag 31:1231–1236

    Article  Google Scholar 

  24. Pfannschmidt J, Muley T, Hoffmann H, Dienemann H (2003) Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experiences in 167 patients. J Thorac Cardiovasc Surg 126:732–739

    Article  PubMed  Google Scholar 

  25. Iizasa T, Suzuki M, Yoshida S, Motohashi S, Yasufuku K, Iyoda A, Shibuya K, Hiroshima K, Nakatani Y, Fujisawa T (2006) Prediction of prognosis and surgical indications for pulmonary metastasectomy from colorectal cancer. Ann Thorac Surg 82:254–260

    Article  PubMed  Google Scholar 

  26. Piltz S, Meimarakis G, Wichmann MW, Hatz R, Schildberg FW, Fuerst H (2002) Long-term results after pulmonary resection of renal cell carcinoma metastases. Ann Thorac Surg 73:1082–1087

    Article  PubMed  Google Scholar 

  27. Anraku M, Yokoi K, Nakagawa K, Fujisawa T, Nakajima J, Akiyama H, Nishimura Y, Kobayashi K, The Metastatic Lung Tumor Study Group of Japan (2004) Pulmonary metastases from uterine malignancies: results of surgical resection in 133 patients. J Thorac Cardiovasc Surg 127:1107–1112

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Clinical Research, National Hospital Organization Shikoku Cancer Center, Ehime, Japan

    Shinsuke Saisho, Masao Nakata, Shigeki Sawada, Motohiro Yamashita, Hideyuki Saeki, Akira Kurita & Shigemitsu Takashima

  2. Division of Thoracic Surgery, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, Japan

    Shinsuke Saisho

  3. Division of Thoracic and Cardiovascular Surgery, Department of Surgery, Kawasaki Medical School Hospital, Okayama, Japan

    Masao Nakata

  4. Department of Surgery, Sumitomo Besshi Hospital, Ehime, Japan

    Hideyuki Saeki

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  1. Shinsuke Saisho
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  2. Masao Nakata
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  3. Shigeki Sawada
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Correspondence to Shinsuke Saisho.

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Saisho, S., Nakata, M., Sawada, S. et al. Evaluation of video-assisted thoracoscopic surgery for pulmonary metastases: 11-years of experience. Surg Endosc 23, 55–61 (2009). https://doi.org/10.1007/s00464-008-9895-y

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  • DOI: https://doi.org/10.1007/s00464-008-9895-y

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