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Background: The development of pulmonary metastases is associated with poor survival of cancer patients. Metastasectomy reveals potential survival benefits for some patients with pulmonary lesions. Aim: To assess a long-term survival of patients who underwent pulmonary metastasectomy (PM). Methods: This retrospective analysis of patients with PM performed at our institute from January 2004 to December 2016 was conducted. Results: Overall 192 patients were included in the analysis: 67 (34.8%) patients with sarcomas of bones and soft tissues, 116 (60.4%) patients with epithelial tumors and in 9 (4.2%) patients with melanoma. In total, 263 surgical interventions were performed that include 252 atypical resections, 32 anatomic resections (including 21 lobectomies) and 5 de-bulking operations. VATS was performed in 48 cases and the Nd:YAG laser was used in 83 operations in 52 patients. In average 4.3 lesions were removed during each surgery (range 1-103). A metastatic lesion was not confirmed by morphology in 44 (15%) patients. Overall 49 post-surgery complications were observed in 46 (23.9%) patients. Postoperative mortality was not revealed. The median overall survival across all patients was 54.5 months. The mean overall survival was significantly higher in patients with epithelial tumors (67 months) than in individuals with sarcomas (27 months, p=0.047). Five-year survival was of 54% and 40.5%, respectively. The analysis did not include 13 patients with lost to follow-up. Conclusions: In a single-center study, the surgical treatment of resectable pulmonary metastases demonstrated a promising result in patients with epithelial tumors and sarcomas. |
