Results of intention-to-treat pulmonary metastasectomies in northern Finland revealing significant number of new lung primary carcinomas: time to move on from wedge resections?
BACKGROUND: A considerable proportion of intended pulmonary metastasectomies is known to turn out as new incidental primary lung cancers in final pathology. We aimed to analyse the trends and results of pulmonary metastasectomies using the intention-to-treat approach with an emphasis on final histop...
Published in: | Journal of Thoracic Disease |
---|---|
Main Authors: | , , , , , , |
Format: | Text |
Language: | English |
Published: |
AME Publishing Company
2023
|
Subjects: | |
Online Access: | http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323574/ https://doi.org/10.21037/jtd-22-1647 |
id |
ftpubmed:oai:pubmedcentral.nih.gov:10323574 |
---|---|
record_format |
openpolar |
spelling |
ftpubmed:oai:pubmedcentral.nih.gov:10323574 2023-07-30T04:05:50+02:00 Results of intention-to-treat pulmonary metastasectomies in northern Finland revealing significant number of new lung primary carcinomas: time to move on from wedge resections? Karjula, Topias Niskakangas, Anne Mustonen, Olli Puro, Iiris Väyrynen, Juha P. Helminen, Olli Yannopoulos, Fredrik 2023-06-13 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323574/ https://doi.org/10.21037/jtd-22-1647 en eng AME Publishing Company http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323574/ http://dx.doi.org/10.21037/jtd-22-1647 2023 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . J Thorac Dis Original Article Text 2023 ftpubmed https://doi.org/10.21037/jtd-22-1647 2023-07-09T01:12:59Z BACKGROUND: A considerable proportion of intended pulmonary metastasectomies is known to turn out as new incidental primary lung cancers in final pathology. We aimed to analyse the trends and results of pulmonary metastasectomies using the intention-to-treat approach with an emphasis on final histopathological findings. METHODS: All intention-to-treat pulmonary metastasectomies performed in Oulu University Hospital between 2000 and 2020 were included in the study. Long term survival was analysed with the Kaplan-Meier method and log-rank tests. A binary logistic regression analysis was performed to calculate odds ratios for incidental primary lung cancer in final histology. RESULTS: A total of 154 intended pulmonary metastasectomies were performed to 127 individual patients. There was an increasing trend in pulmonary metastasectomies during the study period. Despite the increasing trend in comorbidities of the operated patients, the length of hospital stays decreased, and the postoperative complication rates remained stable. In final pathology reports, 9.7% were new primary lung cancers and 13.0% were benign nodules. A long disease-free interval (≥24 months) and smoking history were associated with incidental primary lung cancer in final histology. The short-term 30- and 90-day mortalities after pulmonary metastasectomy were 0.7%. The 5-year survival after pulmonary metastasectomy from all histologies was 52.8%, and from colorectal cancer metastasectomies (n=34) it was 73.5%. CONCLUSIONS: The significant amount of new primary lung cancer lesions in pulmonary metastasectomy specimens highlight the diagnostic importance of pulmonary metastasectomy. A segmentectomy could be considered as a primary procedure in pulmonary metastasectomy in patients with a long disease-free interval and a heavy smoking history. Text Northern Finland PubMed Central (PMC) Meier ENVELOPE(-45.900,-45.900,-60.633,-60.633) Journal of Thoracic Disease 15 6 3319 3329 |
institution |
Open Polar |
collection |
PubMed Central (PMC) |
op_collection_id |
ftpubmed |
language |
English |
topic |
Original Article |
spellingShingle |
Original Article Karjula, Topias Niskakangas, Anne Mustonen, Olli Puro, Iiris Väyrynen, Juha P. Helminen, Olli Yannopoulos, Fredrik Results of intention-to-treat pulmonary metastasectomies in northern Finland revealing significant number of new lung primary carcinomas: time to move on from wedge resections? |
topic_facet |
Original Article |
description |
BACKGROUND: A considerable proportion of intended pulmonary metastasectomies is known to turn out as new incidental primary lung cancers in final pathology. We aimed to analyse the trends and results of pulmonary metastasectomies using the intention-to-treat approach with an emphasis on final histopathological findings. METHODS: All intention-to-treat pulmonary metastasectomies performed in Oulu University Hospital between 2000 and 2020 were included in the study. Long term survival was analysed with the Kaplan-Meier method and log-rank tests. A binary logistic regression analysis was performed to calculate odds ratios for incidental primary lung cancer in final histology. RESULTS: A total of 154 intended pulmonary metastasectomies were performed to 127 individual patients. There was an increasing trend in pulmonary metastasectomies during the study period. Despite the increasing trend in comorbidities of the operated patients, the length of hospital stays decreased, and the postoperative complication rates remained stable. In final pathology reports, 9.7% were new primary lung cancers and 13.0% were benign nodules. A long disease-free interval (≥24 months) and smoking history were associated with incidental primary lung cancer in final histology. The short-term 30- and 90-day mortalities after pulmonary metastasectomy were 0.7%. The 5-year survival after pulmonary metastasectomy from all histologies was 52.8%, and from colorectal cancer metastasectomies (n=34) it was 73.5%. CONCLUSIONS: The significant amount of new primary lung cancer lesions in pulmonary metastasectomy specimens highlight the diagnostic importance of pulmonary metastasectomy. A segmentectomy could be considered as a primary procedure in pulmonary metastasectomy in patients with a long disease-free interval and a heavy smoking history. |
format |
Text |
author |
Karjula, Topias Niskakangas, Anne Mustonen, Olli Puro, Iiris Väyrynen, Juha P. Helminen, Olli Yannopoulos, Fredrik |
author_facet |
Karjula, Topias Niskakangas, Anne Mustonen, Olli Puro, Iiris Väyrynen, Juha P. Helminen, Olli Yannopoulos, Fredrik |
author_sort |
Karjula, Topias |
title |
Results of intention-to-treat pulmonary metastasectomies in northern Finland revealing significant number of new lung primary carcinomas: time to move on from wedge resections? |
title_short |
Results of intention-to-treat pulmonary metastasectomies in northern Finland revealing significant number of new lung primary carcinomas: time to move on from wedge resections? |
title_full |
Results of intention-to-treat pulmonary metastasectomies in northern Finland revealing significant number of new lung primary carcinomas: time to move on from wedge resections? |
title_fullStr |
Results of intention-to-treat pulmonary metastasectomies in northern Finland revealing significant number of new lung primary carcinomas: time to move on from wedge resections? |
title_full_unstemmed |
Results of intention-to-treat pulmonary metastasectomies in northern Finland revealing significant number of new lung primary carcinomas: time to move on from wedge resections? |
title_sort |
results of intention-to-treat pulmonary metastasectomies in northern finland revealing significant number of new lung primary carcinomas: time to move on from wedge resections? |
publisher |
AME Publishing Company |
publishDate |
2023 |
url |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323574/ https://doi.org/10.21037/jtd-22-1647 |
long_lat |
ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
geographic |
Meier |
geographic_facet |
Meier |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_source |
J Thorac Dis |
op_relation |
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10323574/ http://dx.doi.org/10.21037/jtd-22-1647 |
op_rights |
2023 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) . |
op_doi |
https://doi.org/10.21037/jtd-22-1647 |
container_title |
Journal of Thoracic Disease |
container_volume |
15 |
container_issue |
6 |
container_start_page |
3319 |
op_container_end_page |
3329 |
_version_ |
1772818074855014400 |