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01-06-2014 | Thoracic Oncology

Pulmonary Metastasectomy Secondary to Esophageal Carcinoma: Long-Term Survival and Prognostic Factors

Authors: Nao Kobayashi, MD, Tadasu Kohno, MD, PhD, Shusuke Haruta, MD, Sakashi Fujimori, MD, PhD, Hisashi Shinohara, MD, PhD, Masaki Ueno, MD, Harushi Udagawa, MD, PhD

Published in: Annals of Surgical Oncology | Special Issue 3/2014

Abstract

Background

Lung metastasectomy has become an effective treatment for selected patients with colorectal cancer, renal cancer, and other malignancies; however, limited experience has been reported regarding pulmonary metastasectomy for esophageal carcinoma. We reviewed 23 patients with esophageal cancer who underwent pulmonary metastasectomy and investigated their long-term prognosis and prognostic factors.

Methods

A total of 23 patients who underwent 30 curative pulmonary metastasectomies at Toranomon Hospital, Japan, between 2001 and 2011 were included. Four patients underwent repeated metastasectomy. The overall survival rate was examined by the Kaplan–Meier method and various characteristics were assessed by univariate analysis to identify prognostic factors.

Results

The overall 1-, 3-, and 5-year survival rate was 82.6, 46, and 34.1 %, respectively. Median follow-up was 37.4 months (range 1–114 months). Univariate analysis revealed a history of extrapulmonary metastases before pulmonary metastasectomy, poorly differentiated primary esophageal carcinoma, and short disease-free interval (DFI) as unfavorable prognostic factors. Five patients who underwent repeated metastasectomy for recurrent pulmonary metastases survived a mean 58 months (range 24–114 months). The other patients survived a mean 29.4 months (range 1–109 months).

Conclusions

Pulmonary resection for lung metastases from esophageal carcinoma should be considered in selected patients, and repeated metastasectomy should be encouraged. Extrapulmonary metastases before pulmonary metastasectomy, poor differentiation of primary esophageal carcinoma, and short DFI are unfavorable prognostic factors. Due to poor prognosis, metastasectomy in patients with these factors should be more carefully considered before being indicated.

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Title: Pulmonary Metastasectomy Secondary to Esophageal Carcinoma: Long-Term Survival and Prognostic Factors
Authors: Nao Kobayashi, MD
Tadasu Kohno, MD, PhD
Shusuke Haruta, MD
Sakashi Fujimori, MD, PhD
Hisashi Shinohara, MD, PhD
Masaki Ueno, MD
Harushi Udagawa, MD, PhD
Publication date: 01-06-2014
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue Special Issue 3/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-3677-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Pulmonary Metastasectomy Secondary to Esophageal Carcinoma: Long-Term Survival and Prognostic Factors

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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