Pulmonary metastasectomy – A retrospective comparison of surgical outcomes after laser-assisted and conventional resection

Autor: Axel Haverich, Marcus Krüger, I. Zander, S. Lodziewski, Norman Zinne, Ruslan Natanov, Christian Biancosino, Marcel Ricklefs, Taufiek Konrad Rajab, K. Franzke, I. Kropivnitskaya, Jan D. Schmitto
Rok vydání: 2017
Předmět:
Zdroj: European Journal of Surgical Oncology (EJSO). 43:1357-1364
ISSN: 0748-7983
DOI: 10.1016/j.ejso.2016.09.001
Popis: 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.
Databáze: OpenAIRE
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