Objective To investigate the indications of resection for lung metastasis and the surgical procedure and factors affecting the survival.Methods The clinical data of 154 patients of pulmonary metastases after surgical intervention were analyseds retrospectively.Results After surgery,the cumulative 1-,3- and 5-year survival rates were 87.7%,55.3%,37.8%,respectively in our clinical data,of which 3 patients survived for more than 20 years,with an overall median survival of 38.9 months.Mortality and complication rates after surgery were 3.2% (5/154) and 5.8% (9/154).Whether complete resection of lung metastases or not,the number of lung nodules,whether other organs metastasis besides the lung or not,operative modus (thoracotomy and VATS) are prognostic factors.The patients with one latus total pneumonectomy have a shorter survival than the ones with pneumectomy or pulmonary lobectomy.Preoperative pulmonary function is a prognostic factor for the patients with pulmonary lobectomy or one latus total pneumonectomy.Complete resection of pulmonary metastases,a single nodule,no other organs metastasis except the lung and thoracotomy predicts a longer survival whereas disease-free interval (DFI),metastatic locus,pulmonary metastasis size,the status of mediastinal lymph node removal,age,gender,symptom and pathology of the primary tumor were found statistically insignificant prognostic factors.Conclusion Surgical intervention should be undertaken for the indication patients who fit these criteria and thoracotomy is a better choice.For the patients with abnormal preoperative pulmonary function,pulmonary lobectomy or one lateral total pneumonectomy should be attempted with prudence.
Wang Hai-Bing, Chen Xiao-Feng, Zhang Hui, Zhou Wen-Yong, Zhao Ming-Chuan
. Surgical therapeutic strategy and prognostic factors analysis for pulmonary metastasis[J]. Surgical Research and New Technique, 2012
, 1(2)
: 144
-148
.
DOI: 10.3969/j.issn.2095-378X.2012.02.013
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