K Franzke1, R Natanov2, N Zinne2, T K Rajab3, C Biancosino2, I Zander4, S Lodziewski5, M Ricklefs2, I Kropivnitskaya2, J D Schmitto2, A Haverich2, M Krüger6. 1. Division of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. Electronic address: katharina.franzke@stud.mh-hannover.de. 2. Division of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany. 3. Division of Thoracic Surgery, Brigham and Women's Hospital and Harvard Medical School, Boston, USA. 4. Centre for Oncology, Rundestraße 10, Hannover, Germany. 5. Centre for Internal Medicine, DIAKOVERE Friederikenstift, Hannover, Germany. 6. Division of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany; Department of Thoracic Surgery, Martha-Maria Hospital, Halle-Dölau, Germany.
Abstract
INTRODUCTION: Indications and surgical techniques for pulmonary metastasectomy (PME) are controversially discussed issues. Laser-assisted surgery (LAS) is a recent innovation that has been advocated especially in patients with multiple pulmonary metastases (PM). However, there are hardly any studies comparing surgical outcomes after laser-assisted and conventional resection. The aim of the current study was to evaluate the value of LAS in a larger study population. MATERIALS & METHODS: A retrospective analysis was completed on 178 consecutive patients undergoing 236 PMEs at a single center between 2010 and 2015. The main endpoint was survival. Statistical analysis was performed using the Kaplan-Meier method and survival rates were compared with the log rank test. Follow-up was done with special attention to the development of recurrent PM. Local relapse was defined as a recurrent metastasis in direct relation to the previously resected area according to CT scan comparisons. RESULTS: LAS was performed on 256 metastases in 99 patients, non-laser-assisted surgery (NLAS) on 127 metastases in 79 patients. 5-year-survival rates were 69.3% in all patients, 65.7% after LAS and 73.6% after NLAS. There was no statistically significant survival difference after LAS or NLAS (p = 0.41). The rate of local relapse was 0.8% after LAS vs 3.1% after NLAS (p = 0.073). CONCLUSION: Despite a larger number of negative predictors for survival in LAS patients, overall survival (OS) was similar in the compared groups. There was also a trend for a lower risk of local relapses after LAS. Therefore, LAS should be considered a promising method for PME.
INTRODUCTION: Indications and surgical techniques for pulmonary metastasectomy (PME) are controversially discussed issues. Laser-assisted surgery (LAS) is a recent innovation that has been advocated especially in patients with multiple pulmonary metastases (PM). However, there are hardly any studies comparing surgical outcomes after laser-assisted and conventional resection. The aim of the current study was to evaluate the value of LAS in a larger study population. MATERIALS & METHODS: A retrospective analysis was completed on 178 consecutive patients undergoing 236 PMEs at a single center between 2010 and 2015. The main endpoint was survival. Statistical analysis was performed using the Kaplan-Meier method and survival rates were compared with the log rank test. Follow-up was done with special attention to the development of recurrent PM. Local relapse was defined as a recurrent metastasis in direct relation to the previously resected area according to CT scan comparisons. RESULTS:LAS was performed on 256 metastases in 99 patients, non-laser-assisted surgery (NLAS) on 127 metastases in 79 patients. 5-year-survival rates were 69.3% in all patients, 65.7% after LAS and 73.6% after NLAS. There was no statistically significant survival difference after LAS or NLAS (p = 0.41). The rate of local relapse was 0.8% after LAS vs 3.1% after NLAS (p = 0.073). CONCLUSION: Despite a larger number of negative predictors for survival in LASpatients, overall survival (OS) was similar in the compared groups. There was also a trend for a lower risk of local relapses after LAS. Therefore, LAS should be considered a promising method for PME.
Authors: Elena Prisciandaro; Laurens J Ceulemans; Dirk E Van Raemdonck; Herbert Decaluwé; Paul De Leyn; Luca Bertolaccini Journal: J Thorac Dis Date: 2022-07 Impact factor: 3.005
Authors: Andreas Kirschbaum; Andrijana Ivanovic; Thomas Wiesmann; Nikolas Mirow; Christian Meyer Journal: Lasers Med Sci Date: 2021-04-23 Impact factor: 3.161