The optimal timing to resect pulmonary metastasis
The optimal timing to resect pulmonary metastasis
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DOI：
10.1016/j.ejcts.2008.03.002
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发表时间：
2008-06-01
影响因子：
3.4
通讯作者：
Okita, Yutaka
中科院分区：
文献类型：
--
作者：
Tanaka, Yugo;Maniwa, Yoshimasa;Okita, Yutaka
目的：肺转移瘤手术切除的时机尚无标准。在这项研究中，我们探讨了肺动脉瘤切除术的最佳时期。方法：2000年至2005年，68例患者接受了完整的肺转移癌切除术。多因素分析中的临床预后因素。结果如下：从肺转移灶切除到复发的时间和从发现肺转移灶到肺转移灶切除的时间是独立的预后因素。为探讨两种特征之间的关系，将68例患者根据肺切除至随后复发的时间分为两组。术后1年内复发19例（A组），术后1年内未复发白色49例（B组）。A组从检测到肺转移到肺动脉切除术的间隔明显短于B组（2.9个月vs 7.1个月，p = 0.01）。根据这些结果，我们将患者分为两组，并比较生存率。发现肺转移后3个月内行肺切除术的患者（X组，n = 35）生存率明显低于3个月后行手术的患者（Y组，n = 33）。结论：当发现肺转移到肺切除术的时间间隔较短时，许多病例在肺切除术后早期复发。发现肺转移后至少3个月行根治术可明显改善患者的预后。(c)2008年欧洲胸外科协会。Elsevier B.V.出版，保留所有权利。
Objective: There is no criterion for the timing of surgical resection of pulmonary metastasis. In this study, we investigated the optimal period for pulmonary metastasectomy. Methods: Between 2000 and 2005, 68 patients underwent complete pulmonary resection of metastatic cancer. Clinical prognostic factor in multivariate analysis was examined. Results: The interval from pulmonary metastasectomy until subsequent recurrence and the interval from detection of pulmonary metastasis until pulmonary metastasectomy were independent prognostic factors. To investigate the relationship between the two characteristics, the 68 patients were divided into two groups according to the interval from lung metastasectomy until subsequent recurrence. Nineteen patients relapsed within I year after pulmonary metastasectomy (group A), white 49 patients did not relapse within 1 year (group B). The interval from detection of pulmonary metastasis until pulmonary metastasectomy was significantly shorter in group A than in group B (2.9 months vs 7.1 months, p = 0.01). Based on these results, we divided the patients into two different groups and survival was compared. Significantly shorter survival was observed in the patients who underwent pulmonary metastasectomy within 3 months after detection of pulmonary metastasis (group X, n = 35) than in those who underwent the surgery beyond 3 months (group Y, n = 33). Conclusions: There were many cases of early relapse after metastasectomy when the interval from detection of pulmonary metastasis until pulmonary metastasectomy was short. Performing metastasectomy at least three months after detection of pulmonary metastasis may significantly improve the prognosis of patients. (c) 2008 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.