Pulmonary resection for metastatic adrenocortical carcinoma: the National Cancer Institute experience.
Pulmonary resection for metastatic adrenocortical carcinoma: the National Cancer Institute experience.
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DOI：
10.1016/j.athoracsur.2011.05.013
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发表时间：
2011-10
期刊：
影响因子：
--
通讯作者：
Schrump DS
中科院分区：
文献类型：
--
作者：
Kemp CD;Ripley RT;Mathur A;Steinberg SM;Nguyen DM;Fojo T;Schrump DS
肾上腺皮质癌是一种罕见的肿瘤，具有局部复发和远处转移的高倾向，目前尚无有效的系统治疗方法。本研究旨在确定ACC患者行肺动脉瘤切除术的结局。对1979年至2010年ACC患者行肺动脉瘤切除术进行了单机构回顾性分析。26例患者接受了60次肺动脉切除术。15名患者（58%）接受了单侧开胸术，6名（23%）接受了分期开胸术，5名（19%）接受了正中胸骨切开术作为初始胸部手术。病变的中位数量和大小分别为6和2 cm。23例患者（88%）肺部无疾病，14例（54%）完全无疾病。初次肺动脉瘤切除术后的中位总生存期和5年精算生存率分别为40个月和41%，中位潜在随访时间为120个月。同侧胸部复发的中位无复发生存期（RFS）和5年RFS分别为6个月和25%。对侧胸部的中位RFS为5个月。肾上腺切除术后首次复发的时间和原发肿瘤的T分期，而不是辅助或新辅助化疗，与肺动脉切除术后总生存率的增加相关。这项研究代表了对ACC患者行肺动脉切除术结局的最全面回顾。鉴于缺乏有效的系统治疗，肺动脉切除术可能对适当选择的患者有益。
Adrenocortical carcinoma (ACC) is a rare neoplasm with a high propensity for locoregional recurrences and distant metastases for which there are no effective systemic therapies. This study was undertaken to determine outcomes of patients undergoing pulmonary metastasectomy for ACC. A single-institution retrospective review was performed of patients undergoing pulmonary metastasectomy for ACC from 1979 to 2010. Twenty-six patients underwent 60 pulmonary metastasectomies. Fifteen patients (58%) underwent unilateral thoracotomy, 6 (23%) had staged thoracotomies, and 5 (19%) underwent median sternotomy as the initial thoracic procedure. Median number and size of lesions were 6 and 2 cm, respectively. Twenty-three patients (88%) were rendered free of disease in the lung, and 14 (54%) were rendered completely free of disease. Median overall and 5-year actuarial survivals from initial pulmonary metastasectomy were 40 months and 41%, respectively, with a median potential follow-up of 120 months. Median recurrence-free survival (RFS) and 5-year RFS for ipsilateral thoracic recurrences were 6 months, and 25%, respectively. The median RFS in the contralateral thorax was 5 months. Time to first recurrence after adrenalectomy and T stage of the primary tumor, but not adjuvant or neoadjuvant chemotherapy, were associated with increased overall survival after pulmonary metastasectomy. This study represents the most comprehensive review of outcomes of patients undergoing pulmonary metastasectomy for ACC. Given the lack of effective systemic therapies, pulmonary metastasectomy may be beneficial in properly selected patients.
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影响因子：
2.6
作者：
Icard, P;Goudet, P;Proye, C
通讯作者：
Proye, C
影响因子：
3.7
作者：
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DOI：
10.1016/s0889-8529(18)30085-9
发表时间：
1994-09-01
影响因子：
4.5
作者：
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5.9
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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