M Krüger1, J D Schmitto2, B Wiegmann2, T K Rajab3, A Haverich2. 1. Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. Electronic address: Krueger.Marcus@mh-hannover.de. 2. Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. 3. Department of Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, USA.
Abstract
INTRODUCTION: Pulmonary metastasectomy represents an established approach in the treatment of lung metastases related to several solid malignant tumors, promising the chance of long term survival. Regarding the proper timing of metastasectomy both operation promptly after diagnosis and delayed operation after an interval of 3 months are common practice. MATERIALS AND METHODS: A systematic Medline search addressing the optimal timing of metastasectomy was performed. Since the search query "timing of metastasectomy" yields only a limited number of articles, the Medline search was expanded to include the main arguments for prompt metastasectomy ("metastases of metastasis", "growth rate of pulmonary metastases") and for delayed metastasectomy. RESULTS: Based on the data available to date, there is no necessity to expedite the timing of the operation. On the other hand, there is no evidence that a delayed operation, for example after re-staging following an interval of 3 months, provides a benefit. CONCLUSION: Therefore the timing of metastasectomy should only depend on the patient's requirements, such as general state of health and oncologic considerations, such as promising multimodal therapy concepts, extrathoracal tumor manifestations or oncologic type of the primary tumor. A delayed operation seems justified if the indication for resection is questionable due to a high risk of early multilocal recurrence.
INTRODUCTION: Pulmonary metastasectomy represents an established approach in the treatment of lung metastases related to several solid malignant tumors, promising the chance of long term survival. Regarding the proper timing of metastasectomy both operation promptly after diagnosis and delayed operation after an interval of 3 months are common practice. MATERIALS AND METHODS: A systematic Medline search addressing the optimal timing of metastasectomy was performed. Since the search query "timing of metastasectomy" yields only a limited number of articles, the Medline search was expanded to include the main arguments for prompt metastasectomy ("metastases of metastasis", "growth rate of pulmonary metastases") and for delayed metastasectomy. RESULTS: Based on the data available to date, there is no necessity to expedite the timing of the operation. On the other hand, there is no evidence that a delayed operation, for example after re-staging following an interval of 3 months, provides a benefit. CONCLUSION: Therefore the timing of metastasectomy should only depend on the patient's requirements, such as general state of health and oncologic considerations, such as promising multimodal therapy concepts, extrathoracal tumor manifestations or oncologic type of the primary tumor. A delayed operation seems justified if the indication for resection is questionable due to a high risk of early multilocal recurrence.
Authors: Thomas Schweiger; Christoph Nikolowsky; Thomas Graeter; Gernot Seebacher; Jürgen Laufer; Olaf Glueck; Christoph Glogner; Peter Birner; György Lang; Walter Klepetko; Hendrik Jan Ankersmit; Konrad Hoetzenecker Journal: Clin Exp Metastasis Date: 2015-10-23 Impact factor: 5.150
Authors: Jon Zabaleta; Borja Aguinagalde; Iker Lopez; Arantza Fernandez-Monge; Jose M Izquierdo; Jose I Emparanza Journal: Cancer Biol Med Date: 2017-08 Impact factor: 4.248