Jun Kanamori1,2, Keiju Aokage3, Tomoyuki Hishida3, Junji Yoshida3, Masahiro Tsuboi3, Takeo Fujita1, Masato Nagino2, Hiroyuki Daiko4. 1. Division of Esophageal Surgery, National Cancer Center Hospital East , Kashiwa. 2. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya. 3. Division of Thoracic Surgery, National Cancer Center Hospital East, Kashiwa, Japan. 4. Division of Esophageal Surgery, National Cancer Center Hospital East , Kashiwa hdaikou@east.ncc.go.jp.
Abstract
OBJECTIVE: The purposes of this study were to determine the role of surgical treatment and to identify factors affecting survival of patients undergoing resection of pulmonary metastatic tumors from esophageal carcinoma. METHODS: We reviewed 33 patients who had undergone resection of pulmonary metastatic tumors from esophageal carcinoma after definitive treatment. RESULTS: The operative morbidity rate was only 5%, no patients died within 30 days after resection, and complete resection was achieved in 30 patients. The overall 1-, 3- and 5-year survival rates after pulmonary metastasectomy were 79.4, 47.8 and 43.0%, respectively, and the median survival time was 17.9 months. The factors found on univariate analysis to affect survival significantly were disease-free interval <16 months and nodal involvement of the primary tumor. The most frequent pattern of initial recurrence after pulmonary resection was distant metastasis (70%). CONCLUSIONS: We demonstrated the safety and effectiveness of surgical resection for selected patients with pulmonary metastatic tumors from esophageal carcinoma. However, with a high recurrence rate in patients with negative prognostic factors, adjuvant systemic chemotherapy after pulmonary resection should be considered.
OBJECTIVE: The purposes of this study were to determine the role of surgical treatment and to identify factors affecting survival of patients undergoing resection of pulmonary metastatic tumors from esophageal carcinoma. METHODS: We reviewed 33 patients who had undergone resection of pulmonary metastatic tumors from esophageal carcinoma after definitive treatment. RESULTS: The operative morbidity rate was only 5%, no patients died within 30 days after resection, and complete resection was achieved in 30 patients. The overall 1-, 3- and 5-year survival rates after pulmonary metastasectomy were 79.4, 47.8 and 43.0%, respectively, and the median survival time was 17.9 months. The factors found on univariate analysis to affect survival significantly were disease-free interval <16 months and nodal involvement of the primary tumor. The most frequent pattern of initial recurrence after pulmonary resection was distant metastasis (70%). CONCLUSIONS: We demonstrated the safety and effectiveness of surgical resection for selected patients with pulmonary metastatic tumors from esophageal carcinoma. However, with a high recurrence rate in patients with negative prognostic factors, adjuvant systemic chemotherapy after pulmonary resection should be considered.
Authors: Costanza Chiapponi; Felix Berlth; Patrick S Plum; Christopher Betzler; Dirk L Stippel; Felix Popp; Christiane J Bruns Journal: Visc Med Date: 2017-02-15