Pulmonary metastasectomy: outcomes and issues according to the type of surgical resection

General Thoracic and Cardiovascular Surgery - Tập 63 - Trang 320-330 - 2015
Masahiko Higashiyama1, Toshiteru Tokunaga1, Tomoyuki Nakagiri1, Daisuke Ishida1, Hidenori Kuno1, Jiro Okami1
1Department of General Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

Tóm tắt

According to a recent report by the Committee for Scientific Affairs of the Japanese Association for Thoracic Surgery, pulmonary metastasectomy accounted for as many as 10.2 % of all entry cases of general thoracic surgery, and its use is increasing year by year. Accordingly, many studies have examined the surgical procedures used during pulmonary metastasectomy for metastases from primary tumors affecting various organs as well as the outcomes of and indications for such procedures, but some problems remain. In this article, the following questions related to the surgical approach and the type of resection used during pulmonary metastasectomy are reviewed: (1) Wedge resection—what is a safe margin for preventing local recurrence? (2) What is the clinical significance of node sampling/dissection during pulmonary metastasectomy? and (3) When is segmentectomy necessary? In addition, we discuss: (4) open thoracotomy vs. video-assisted thoracoscopic surgery (VATS), (5) repeated metastasectomy for pulmonary metastases, (6) the surgical approach for bilateral pulmonary metastasectomy, (7) pneumonectomy, and (8) pulmonary metastasectomy combined with resection of the neighboring organs.

Tài liệu tham khảo

Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery, Masuda M, Kuwano H, Okumura M, Amano J, Arai H, Endo S, Doki Y, Kobayashi J, Motomura N, Nishida H, Saiki Y, Tanaka F, Tanemoto K, Toh Y, Yokomise H. Thoracic and cardiovascular surgery in Japan during 2012: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2014;62(12):734–64. Bartlett EK, Simmons KD, Wachtel H, Roses RE, Fraker DL, Kelz RR, Karakousis GC. The rise in metastasectomy across cancer types over the past decade. Cancer. 2014;. doi:10.1002/cncr.29134. Thomford NR, Woolner LB, Clagett OT. The surgical treatment of metastatic tumors in the lungs. J Thorac Cardiovasc Surg. 1965;49:357–63. Rusch VW. Pulmonary metastasectomy. Current indications. Chest. 1995;107:322S–32S. The International Registry of Lung Metastases. Long-term results of lung metastasectomy: Prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg. 1997;113:37–49. Kondo H, Okumura T, Ohde Y, Nakagawa K. Surgical treatment for metastatic malignancies. Pulmonary metastasis: indications and outcomes. Int J Clin Oncol. 2005;10(2):81–5. Yano T, Shoji F, Maehara Y. Current status of pulmonary metastasectomy from primary epithelial tumors. Surg Today. 2009;39(2):91–7. Hornbech K, Ravn J, Steinbrüchel DA. Current status of pulmonary metastasectomy. Eur J Cardiothorac Surg. 2011;39(6):955–62. Ripley RT, Downey RJ. Pulmonary metastasectomy. J Surg Oncol. 2014;109:42–6. Nichols FC. Pulmonarymetastasectomy: role of pulmonary metastasectomy and type of surgery. Curr Treat Options Oncol. 2014;15(3):465–75. Kodama K, Doi O, Higashiyama M, Tatsuta M, Iwanaga T. Surgical management of lung metastases. Usefulness of resection with the neodymium: yttrium-aluminum-garnet laser with median sternotomy. J Thorac Cardiovasc Surg. 1991;101(5):901–8. Rolle A, Koch R, Alpard SK, Zwischenberger JB. Lobe-sparing resection of multiple pulmonary metastases with a new 1318-nm Nd:YAG laser–first 100 patients. Ann Thorac Surg. 2002;74(3):865–9. Shiono S, Ishii G, Nagai K, Yoshida J, Nishimura M, Murata Y, Tsuta K, Nishiwaki Y, Kodama T, Ochiai A. Predictive factors for local recurrence of resected colorectal lung metastases. Ann Thorac Surg. 2005;80(3):1040–5. Kim S, Ott HC, Wright CD, Wain JC, Morse C, Gaissert HA, Donahue DM, Mathisen DJ, Lanuti M. Pulmonary resection of metastatic sarcoma: prognostic factors associated with improved outcomes. Ann Thorac Surg. 2011;92:1780–7. Welter S, Grabellus F, Bauer S, Schuler M, Eberhardt W, Tötsch M, Stamatis G. Growth patterns of lung metastases from sarcoma: prognostic and surgical implications from histology. Interact Cardiovasc Thorac Surg. 2012;15(4):612–7. Miyazaki T, Hasegawa Y, Hanai N, Ozawa T, Hirakawa H, Suzuki A, Okamoto H, Harata I. Survival impact of pulmonary metastasectomy for patients with head and neck cancer. Head Neck. 2013;35(12):1745–51. Welter S, Theegarten D, Trarbach T, Maletzki F, Stamatis G, Tötsch M. Safety distance in the resection of colorectal lung metastases: a prospective evaluation of satellite tumor cells with immunohistochemistry. J Thorac Cardiovasc Surg. 2011;141(5):1218–22. Higashiyama M, Kodama K, Takami K, Higaki N, Yokouchi H, Nakayama T, Murata K, Kameyama M, Ashimura J, Naruse Y, Nagumo S. Intraoperative lavage cytologic analysis of surgical margins as a predictor of local recurrence in pulmonary metastasectomy. Arch Surg. 2002;137(4):469–74. Higashiyama M, Kodama K, Takami K, Higaki N, Nakayama T, Yokouchi H. Intraoperative lavage cytologic analysis of surgical margins in patients undergoing limited surgery for lung cancer. J Thorac Cardiovasc Surg. 2003;125(1):101–7. Sawabata N, Mori T, Iuchi K, Maeda H, Ohta M, Kuwahara O. Cytologic examination of surgical margin of excised malignant pulmonary tumor: methods and early results. J Thorac Cardiovasc Surg. 1999;117(3):618–9. Gonzalez M, Poncet A, Combescure C, Robert J, Ris HB, Gervaz P. Risk factors for survival after lung metastasectomy in colorectal cancer patients: a systematic review and meta-analysis. Ann Surg Oncol. 2013;20(2):572–9. Treasure T. Pulmonarymetastasectomy for colorectal cancer: recent reports prompt a review of the available evidence. Curr Colorectal Cancer Rep. 2014;10(3):296–302. Saito Y, Omiya H, Kohno K, Kobayashi T, Itoi K, Teramachi M, Sasaki M, Suzuki H, Takao H, Nakade M. Pulmonary metastasectomy for 165 patients with colorectal carcinoma: A prognostic assessment. J Thorac Cardiovasc Surg. 2002;124(5):1007–13. Higashiyama M, Kodama K, Higaki N, Takami K, Murata K, Kameyama M, Yokouchi H. Surgery for pulmonary metastases from colorectal cancer: the importance of prethoracotomy serum carcinoembryonic antigen as an indicator of prognosis. Jpn J Thorac Cardiovasc Surg. 2003;51(7):289–96. Inoue M, Ohta M, Iuchi K, Matsumura A, Ideguchi K, Yasumitsu T, Nakagawa K, Fukuhara K, Maeda H, Takeda S, Minami M, Ohno Y, Matsuda H. Thoracic Surgery Study Group of Osaka University. Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma. Ann Thorac Surg. 2004;78(1):238–44. Iida T, Nomori H, Shiba M, Nakajima J, Okumura S, Horio H, Matsuguma H, Ikeda N, Yoshino I, Ozeki Y, Takagi K, Goya T, Kawamura M, Hamada C, Kobayashi K. Metastatic Lung Tumor Study Group of Japan. Prognostic factors after pulmonary metastasectomy for colorectal cancer and rationale for determining surgical indications: a retrospective analysis. Ann Surg. 2013;257(6):1059–64. Watanabe K, Nagai K, Kobayashi A, Sugito M, Saito N. Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer. Br J Surg. 2009;96(9):1058–65. Bölükbas S, Sponholz S, Kudelin N, Eberlein M, Schirren J. Risk factors for lymph node metastases and prognosticators of survival in patients undergoing pulmonary metastasectomy for colorectal cancer. Ann Thorac Surg. 2014;97(6):1926–32. Renaud S, Alifano M, Falcoz PE, Magdeleinat P, Santelmo N, Pagès O, Massard G, Régnard JF. Does nodal status influence survival? Results of a 19-year systematic lymphadenectomy experience during lung metastasectomy of colorectal cancer. Interact Cardiovasc Thorac Surg. 2014;18(4):482–7. Kanzaki R, Higashiyama M, Fujiwara A, Tokunaga T, Maeda J, Okami J, Nishimura K, Kodama K. Long-term results of surgical resection for pulmonary metastasis from renal cell carcinoma: a 25-year single-institution experience. Eur J Cardiothorac Surg. 2011;39(2):167–72. Pfannschmidt J, Hoffmann H, Muley T, Krysa S, Trainer C, Dienemann H. Prognostic factors for survival after pulmonary resection of metastatic renal cell carcinoma. Ann Thorac Surg. 2002;74(5):1653–7. Winter H, Meimarakis G, Angele MK, Hummel M, Staehler M, Hoffmann RT, Hatz RA, Löhe F. Tumor infiltrated hilar and mediastinal lymph nodes are an independent prognostic factor for decreased survival after pulmonary metastasectomy in patients with renal cell carcinoma. J Urol. 2010;184(5):1888–94. Kanzaki R, Higashiyama M, Fujiwara A, Tokunaga T, Maeda J, Okami J, Nishimura K, Kodama K. Outcome of surgical resection of pulmonary metastasis from urinary tract transitional cell carcinoma. Interact Cardiovasc Thorac Surg. 2010;11(1):60–4. Shiono S, Kawamura M, Sato T, Okumura S, Nakajima J, Yoshino I, Ikeda N, Horio H, Akiyama H, Kobayashi K. Metastatic Lung Tumor Study Group of Japan. Pulmonary metastasectomy for pulmonary metastases of head and neck squamous cell carcinomas. Ann Thorac Surg. 2009;88(3):856–60. Shiono S, Matsutani N, Okumura S, Nakajima J, Horio H, Kohno M, Ikeda N, Kawamura M; The Metastatic Lung Tumor Study Group of Japan. The prognostic impact of lymph-node dissection on lobectomy for pulmonary metastasis. Eur J Cardiothorac Surg. 2015 (in press). Anraku M, Yokoi K, Nakagawa K, Fujisawa T, Nakajima J, Akiyama H, Nishimura Y, Kobayashi K. Pulmonary metastases from uterine malignancies: results of surgical resection in 133 patients. J Thorac Cardiovasc Surg. 2004;127(4):1107–12. Seebacher G, Decker S, Fischer JR, Held M, Schäfers HJ, Graeter TP. Unexpected lymph node disease in resections for pulmonary metastases. Ann Thorac Surg. 2015;99(1):231–6. Hamaji M, Cassivi SD, Shen KR, Allen MS, Nichols FC, Deschamps C, Wigle DA. Is lymph node dissection required in pulmonary metastasectomy for colorectal adenocarcinoma? Ann Thorac Surg. 2012;94(6):1796–800. Berry MF. Role of segmentectomy for pulmonary metastases. Ann Cardiothorac Surg. 2014;3(2):176–82. Althagafi KT, Alashgar OA, Almaghrabi HS, Nasralla A, Ahmed MH, Alshehri AM, Saleh WN, Alkattan KM. Missed pulmonary metastasis. Asian Cardiovasc Thorac Ann. 2014;22(2):183–6. Eckardt J, Licht PB. Thoracoscopic or open surgery for pulmonarymetastasectomy: an observer blinded study. Ann Thorac Surg. 2014;98(2):466–9. Nakas A, Klimatsidas MN, Entwisle J, Martin-Ucar AE, Waller DA. Video-assisted versus open pulmonary metastasectomy: the surgeon’s finger or the radiologist’s eye? Eur J Cardiothorac Surg. 2009;36(3):469–74. Carballo M, Maish MS, Jaroszewski DE, Holmes CE. Video-assisted thoracic surgery (VATS) as a safe alternative for the resection of pulmonary metastases: a retrospective cohort study. J Cardiothorac Surg. 2009;24(4):13. Gossot D, Radu C, Girard P, Le Cesne A, Bonvalot S, Boudaya MS, Validire P, Magdeleinat P. Resection of pulmonary metastases from sarcoma: can some patients benefit from a less invasive approach? Ann Thorac Surg. 2009;87(1):238–43. Greenwood A, West D. Is a thoracotomy rather than thoracoscopic resection associated with improved survival after pulmonary metastasectomy? Interact Cardiovasc Thorac Surg. 2013;17(4):720–4. Long H, Zheng Y, Situ D, Ma G, Lin Z, Wang J. Hand-assisted thoracoscopic surgery for bilateral lungmetastasectomy through sternocostal triangle access. Ann Thorac Surg. 2011;91(3):852–8. Kandioler D, Kromer E, Tuchler H, End A, Muller MR, Wolner E, Eckersberger F. Long-term results after repeated surgical removal of pulmonarymetastases. Ann Thorac Surg. 1998;65:909–12. Kanzaki R, Higashiyama M, Oda K, Fujiwara A, Tokunaga T, Maeda J, Okami J, Tanaka K, Shingai T, Noura S, Ohue M, Kodama K. Outcome of surgical resection for recurrent pulmonarymetastasis from colorectal carcinoma. Am J Surg. 2011;202(4):419–26. Chen F, Miyahara R, Bando T, Okubo K, Watanabe K, Nakayama T, Toguchida J, Date H. Repeat resection of pulmonary metastasis is beneficial for patients with osteosarcoma of the extremities. Interact Cardiovasc Thorac Surg. 2009;9(4):649–53. Mizuno T, Taniguchi T, Ishikawa Y, Kawaguchi K, Fukui T, Ishiguro F, Nakamura S, Yokoi K. Pulmonarymetastasectomy for osteogenic and soft tissue sarcoma: who really benefits from surgical treatment? Eur J Cardiothorac Surg. 2013;43(4):795–9. Park JS, Kim HK, Choi YS, Kim K, Shim YM, Jo J, Lee WY, Chun HK, Park YS, Kang WK, Kim J. Outcomes after repeated resection for recurrent pulmonary metastases from colorectal cancer. Ann Oncol. 2010;21(6):1285–9. Salah S, Watanabe K, Park JS, Addasi A, Park JW, Zabaleta J, Ardissone F, Kim J, Riquet M, Nojiri K, Gisabella M, Kim SY, Tanaka K. Repeated resection of colorectal cancer pulmonary oligometastases: pooled analysis and prognostic assessment. Ann Surg Oncol. 2013;20(6):1955–61. Briccoli A, Rocca M, Salone M, Bacci G, Ferrari S, Balladelli A, Mercuri M. Resection of recurrent pulmonary metastases in patients with osteosarcoma. Cancer. 2005;104(8):1721–5. Tsuchiya H, Kanazawa Y, Abdel-Wanis ME, Asada N, Abe S, Isu K, Sugita T, Tomita K. Effect of timing of pulmonary metastases identification on prognosis of patients with osteosarcoma: the Japanese Musculoskeletal Oncology Group study. J Clin Oncol. 2002;20(16):3470–7. Subbiah IM, Blackmon SH, Correa AM, Kee B, Vaporciyan AA, Swisher SG, Eng C. Preoperative chemotherapy prior to pulmonary metastasectomy in surgically resected primary colorectal carcinoma. Oncotarget. 2014;5(16):6584–93. Mizuno Y, Iwata H, Shirahashi K, Takemura H. One-stage bilateral pulmonary resections for pulmonary metastases. Gen Thorac Cardiovasc Surg. 2014;62(1):53–7. Molnar TF, Gebitekin C, Turna A. What are the considerations in the surgical approach in pulmonary metastasectomy? J Thorac Oncol. 2010;5(6 Suppl 2):S140–4. Kodama K, Higashiyama M, Yokouchi H, Takami K, Doki Y, Kabuto T. Transmediastinal approach to exploring the lung contralateral to the thoracotomy site. Jpn J Thorac Cardiovasc Surg. 2001;49(5):267–72. Wohlgemut JM, Salami M, Buchan K. Bilateralpulmonarymetastasectomy through right thoracotomy. Ann Thorac Surg. 2013;96(1):323–5. Suda T, Ashikari S, Tochii S, Sugimura H, Hattori Y. Single-incision subxiphoid approach for bilateral metastasectomy. Ann Thorac Surg. 2014;97(2):718–9. Ehrenhaft JL, Lawrence MS, Sensenig DM. Pulmonary resections for metastatic lesions. AMA Arch Surg. 1958;77(4):606–12. Putnam JB Jr, Suell DM, Natarajan G, Roth JA. Extended resection of pulmonary metastases: is the risk justified? Ann Thorac Surg. 1993;55(6):1440–6. Spaggiari L, Grunenwald DH, Girard P, Solli P, Le Chevalier T. Pneumonectomy for lung metastases: indications, risks, and outcome. Ann Thorac Surg. 1998;66(6):1930–3. Koong HN, Pastorino U, Ginsberg RJ. Is there a role for pneumonectomy in pulmonary metastases? International Registry of Lung Metastases. Ann Thorac Surg. 1999;68(6):2039–43. Hendriks JM, van Putte B, Romijn S, van den Brande J, Vermorken JB, van Schil PE. Pneumonectomy for lung metastases: report of ten cases. Thorac Cardiovasc Surg. 2003;51(1):38–41. Verhagen AF, Lacquet LK. Completion pneumonectomy. A retrospective analysis of indications and results. Eur J Cardiothorac Surg. 1996;10(4):238–41. Grunenwald D, Spaggiari L, Girard P, Baldeyrou P, Filaire M, Dennewald G. Completion pneumonectomy for lung metastases: is it justified? Eur J Cardiothorac Surg. 1997;12(5):694–7. Fujimoto T, Zaboura G, Fechner S, Hillejan L, Schröder T, Marra A, Krbek T, Hinterthaner M, Greschuchna D, Stamatis G. Completion pneumonectomy: current indications, complications, and results. J Thorac Cardiovasc Surg. 2001;121(3):484–90. Jungraithmayr W, Hasse J, Stoelben E. Completion pneumonectomy for lung metastases. Eur J Surg Oncol. 2004;30(10):1113–7. Guggino G, Doddoli C, Barlesi F, Acri P, Chetaille B, Thomas P, Giudicelli R, Fuentes P. Completion pneumonectomy in cancer patients: experience with 55 cases. Eur J Cardiothorac Surg. 2004;25(3):449–55. Chataigner O, Fadel E, Yildizeli B, Achir A, Mussot S, Fabre D, Mercier O, Dartevelle PG. Factors affecting early and long-term outcomes after completion pneumonectomy. Eur J Cardiothorac Surg. 2008;33(5):837–43. Tanju S, Ziyade S, Erus S, Bayrak Y, Toker A, Dilege S. Extended resection: is it feasible for pulmonary metastases? Ann Surg Oncol. 2010;17(7):1912–6.