Outcomes and prognostic factors of survival after pulmonary resection

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Nov 8, 2012 - Because gastric cancer metastases to the lung generally occur as lymphangitic carcinomatosis or numerous lesions, metastasectomy is rarely ...
ORIGINAL ARTICLE

European Journal of Cardio-Thoracic Surgery 43 (2013) e13–e16 doi:10.1093/ejcts/ezs574 Advance Access publication 8 November 2012

Outcomes and prognostic factors of survival after pulmonary resection for metastatic gastric cancer Satoshi Shionoa,*, Toru Satoa, Hirotoshi Horiob, Masayuki Chidac, Haruhisa Matsugumad, Yuichi Ozekie, Jun Nakajimaf and Sakae Okumurag, The Metastatic Lung Tumor Study Group of Japan a b c d e f g

Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan Department of General Thoracic Surgery, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan Department of General Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan Division of Thoracic Surgery, Tochigi Cancer Center, Tochigi, Japan Department of Surgery II, National Defense Medical College, Saitama, Japan Department of Cardiothoracic Surgery, University of Tokyo, Tokyo, Japan Department of Chest Surgery, Cancer Institute Hospital, Tokyo, Japan

Received 29 July 2012; received in revised form 18 September 2012; accepted 2 October 2012

Abstract OBJECTIVES: Gastric cancer is the most common malignant tumour in Japan. Because gastric cancer metastases to the lung generally occur as lymphangitic carcinomatosis or numerous lesions, metastasectomy is rarely indicated. Therefore, the role of resectable pulmonary metastasectomy in gastric cancer is still unclear. The objective of this study was to determine the surgical outcomes and prognostic factors for survival after pulmonary resection of resectable metastatic gastric cancer. METHODS: The database of the Metastatic Lung Tumor Study Group of Japan was retrospectively reviewed. Between March 1980 and March 2011, 3831 patients underwent pulmonary metastasectomy. Fifty-one patients undergoing surgery for metastatic gastric cancer were analysed, and the survival parameters and prognostic factors after pulmonary metastasectomy were determined. RESULTS: The median time to recurrence after lung resection was 6 months (range, 0–29 months). The overall 5-year survival rate after pulmonary metastasectomy was 28%, and the median survival time was 29 months. Both univariate and multivariate analysis found that a disease-free interval