Dataset Information

Metachronous pulmonary metastasis after radical esophagectomy for esophageal cancer: prognosis and outcome.

ABSTRACT:

Background

Few reports discuss the outcome of pulmonary metastasis after radical esophagectomy for esophageal cancer. To clarify the data from such cases, we conducted a retrospective study on the clinical outcome of patients who developed pulmonary metastasis after undergoing radical esophagectomy.

Methods

We retrospectively reviewed the prognosis and clinical outcome of 25 patients who developed metachronous pulmonary metastasis after esophagectomy for esophageal cancer.

Results

The site of recurrence was pulmonary without extrapulmonary metastasis in 14 patients and extrapulmonary metastasis was observed in 11. Nineteen patients had multiple pulmonary metastasis and 6 had solitary pulmonary metastasis. Twenty-four of patients underwent systemic chemotherapy during initial treatment for metastatic lesions. Pulmonary metastasectomy was indicated in 5 patients with solitary metastasis. The actual 1-, 2- and 4-year survival rates were 60%, 36% and 27%, respectively. Gender, operative procedure, and postoperative morbidity were not significant prognostic factors. However, pathological staging of primary esophageal cancer was a significant prognostic factor. Survival was significantly worse in patients who did not undergo resection than in those who did. The number of pulmonary metastasis, complicated extrapulmonary metastasis and the time of recurrence were also significant prognostic factors.

Conclusions

Multiple pulmonary metastases or complicated extrapulmonary metastasis were unfavorable prognostic factors for patients with pulmonary metastasis arising from esophageal cancer. Although, surgical intervention is not recommended in such cases, metastasectomy is an acceptable choice of treatment for solitary pulmonary metastasis.

SUBMITTER: Takemura M

PROVIDER: S-EPMC3504510 | biostudies-literature | 2012 Oct

REPOSITORIES: biostudies-literature

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Publications

Metachronous pulmonary metastasis after radical esophagectomy for esophageal cancer: prognosis and outcome.

Takemura Masashi M Sakurai Katsunobu K Takii Mamiko M Yoshida Kayo K

Journal of cardiothoracic surgery 20121002

<h4>Background</h4>Few reports discuss the outcome of pulmonary metastasis after radical esophagectomy for esophageal cancer. To clarify the data from such cases, we conducted a retrospective study on the clinical outcome of patients who developed pulmonary metastasis after undergoing radical esophagectomy.<h4>Methods</h4>We retrospectively reviewed the prognosis and clinical outcome of 25 patients who developed metachronous pulmonary metastasis after esophagectomy for esophageal cancer.<h4>Resu ...[more]

PMID: 23031450

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Project description:Background:Robot-assisted minimally invasive esophagectomy (RAMIE) reduces postoperative respiratory complications and enables meticulous mediastinal lymphadenectomy. However, whether adding a robotic abdominal procedure to a robotic thoracic procedure can result in better outcomes is unclear. We examined outcomes after total-RAMIE (T-RAMIE) and compared them with the outcomes after hybrid-RAMIE (H-RAMIE). Methods:Total of 227 patients who underwent robotic esophagectomy for esophageal cancer were included. T-RAMIE was defined as esophagectomy performed robotically in both the thoracic and abdominal cavities. Laparotomy was used instead of the robotic procedure in H-RAMIE. T-RAMIE was performed in 144 patients (63.4%), and propensity score matching produced 49 matched pairs from each group. Early and long-term clinical outcomes between the two groups were compared. Results:T-RAMIE was mostly performed for upper or mid-thoracic squamous cell carcinoma (n=119, 82.6%) and cervical anastomosis, and three-field lymphadenectomy was performed in 113 (78.5%) and 54 (37.5%) patients, respectively. One laparotomy conversion was necessary because of severe obesity. The propensity-matched analysis demonstrated that T-RAMIE showed a comparable 90-day mortality rate with H-RAMIE (0% vs. 6.1%, P=0.083). The incidence rates of total (63.3% vs. 63.3%; P=1.000), abdominal (8.2% vs. 14.3%; P=0.366), and respiratory complications (10.2% vs. 10.2%; P=1.000) were not different between two groups. The number of harvested abdominal lymph nodes was similar (12.4±9.0 vs. 12.3±8.9; P=0.992). Median follow-up duration for T-RAMIE and H-RAMIE was 16.3 and 23.5 months, respectively. Two-year overall survival rate (86.2% in T-RAMIE vs. 77.6% in H-RAMIE; P=0.150) and recurrence-free survival (76.6% in T-RAMIE vs. 62.2% in H-RAMIE; P=0.280) were comparable between the two groups. Conclusions:In this matched analysis, T-RAMIE and H-RAMIE showed comparable early outcomes and long-term survival. The low tendencies of early mortality and conversion rate of T-RAMIE suggest that it might be a safe alternative to open stomach mobilization and abdominal lymphadenectomy.

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Dataset Information

Metachronous pulmonary metastasis after radical esophagectomy for esophageal cancer: prognosis and outcome.

Background

Methods

Results

Conclusions

Publications

Metachronous pulmonary metastasis after radical esophagectomy for esophageal cancer: prognosis and outcome.

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