Original Articles
Resection of Pulmonary Metastases in 148 Patients: Analysis of Prognostic Factors
Javier Ayarra Jarne
, Rafael Jiménez Merchán, Miguel Congregado Loscertales, Juan Carlos Girón Arjona, Gregorio Gallardo Valera, Ana Isabel Triviño Ramírez, Carlos Arenas Linares, Jesús Loscertales
Corresponding author
javierayarra@tecnifip.com
Correspondence: Dr J. Ayarra Jarne Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena Avda. Dr. Fedriani, s/n 41071 Sevilla, Spain
Correspondence: Dr J. Ayarra Jarne Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena Avda. Dr. Fedriani, s/n 41071 Sevilla, Spain
Servicio de Cirugía General y Torácica, Hospital Universitario Virgen Macarena, Sevilla, Spain
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Ayarra Jarne Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena Avda. Dr. Fedriani, s/n 41071 Sevilla, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-08-15" "fechaAceptado" => "2008-02-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155042" "palabras" => array:6 [ 0 => "Pulmonary metastases" 1 => "Pulmonary resection" 2 => "Video-assisted thoracoscopic surgery" 3 => "Risk factors" 4 => "Prognosis" 5 => "Survival" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155041" "palabras" => array:6 [ 0 => "Metástasis pulmonares" 1 => "Resección pulmonar" 2 => "VATS" 3 => "Factores de riesgo" 4 => "Pronóstico" 5 => "Supervivencia" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To evaluate the prognostic factors for survival in a series of patients who underwent surgery for pulmonary metastases from primary tumors in distinct organs.</p> <span class="elsevierStyleSectionTitle">Patients and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">This was a retrospective study of 148 patients operated between May 2001 and May 2007. Multivariate analysis was used to evaluate overall survival. Patients scheduled for tumorectomy were included provided their primary tumor was controlled and they had no extrathoracic recurrence and adequate cardiorespiratory function. The influence of the following prognostic factors was analyzed: number and diameter of the metastases, lymph node infiltration, complete resection, and, above all, histological type. A significance level of 95% was used.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">A total of 90 men (60.81%) and 58 women (39.19%) were operated. The mean (SD) age was 56.5 (9.7) years. The actuarial survival at 6 years was 30.3% (n=45) and the median survival was 34 months. The factors that affected survival were the number of metastases (<span class="elsevierStyleItalic">P</span><.05), diameter of the lesions (<span class="elsevierStyleItalic">P</span><.05), lymph node infiltration (<span class="elsevierStyleItalic">P</span><.05), complete resection (<span class="elsevierStyleItalic">P</span><.05), and, above all, histological type (<span class="elsevierStyleItalic">P</span><.05). Tumorectomy was the most commonly performed operation.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">These results suggest that, in the absence of other therapeutic options and contraindications, we should operate on patients in whom the primary tumor is controlled and in whom complete resection can be performed. Even if factors associated with poor prognosis are present, the outcomes are always better than when surgery is not performed, particularly in view of the relatively low morbidity and mortality associated with this type of surgery.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Evaluar los factores pronósticos de supervivencia en una serie de pacientes intervenidos por metástasis pulmonares de diferentes tumores y órganos.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio retrospectivo de 148 pacientes intervenidos entre mayo de 2001 y mayo de 2007, y se ha aplicado un análisis multivariante para valorar la supervivencia global. Los criterios de inclusión fueron: control del tumor primario, sin recurrencia extratorácica y función cardiorrespiratoria suficiente, siempre con intención de tumorectomía. Se valoró qué influencia tenían en el pronóstico los siguientes factores: número de metástasis, diámetro de éstas, adenopatías invadidas, cirugía completa y, sobre todo, tipo histológico, para un nivel de significación del 95%.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">En total se intervino a 90 varones (60,81%) y 58 mujeres (39,19%). La edad media ± desviación estándar era de 56,5 ± 9,7 años. Se obtuvo una supervivencia actuarial a 6 años del 30,3% (n = 45), con una mediana de supervivencia de 34 meses. Los factores que influyeron en el pronóstico fueron el número de metástasis (p < 0,05), el diámetro de éstas (p < 0,05), la presencia de adenopatías invadidas (p < 0,05), la cirugía completa (p < 0,05) y, sobre todo, el tipo histológico (p < 0,05). La tumorectomía fue la intervención más realizada.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los resultados avalan que aceptemos para tratamiento quirúrgico a los pacientes sin otra posibilidad terapéutica a quienes pueda realizarse una resección completa, que tengan el tumor primario controlado y no presenten otras contraindicaciones, pues, aunque en presencia de ciertos factores empeora la supervivencia, los resultados son siempre mejores que con la abstención quirúrgica, máxime si se tienen en cuenta las cifras relativamente bajas de morbilidad y mortalidad con este tipo de cirugía.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:38 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary disease" "autores" => array:1 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 4 | 9 |
| 2024 October | 31 | 18 | 49 |
| 2024 September | 30 | 17 | 47 |
| 2024 August | 45 | 40 | 85 |
| 2024 July | 37 | 22 | 59 |
| 2024 June | 42 | 42 | 84 |
| 2024 May | 50 | 24 | 74 |
| 2024 April | 25 | 24 | 49 |
| 2024 March | 18 | 19 | 37 |
| 2024 February | 19 | 24 | 43 |
| 2023 March | 2 | 4 | 6 |
| 2023 February | 22 | 16 | 38 |
| 2023 January | 16 | 28 | 44 |
| 2022 December | 21 | 30 | 51 |
| 2022 November | 22 | 28 | 50 |
| 2022 October | 30 | 29 | 59 |
| 2022 September | 20 | 25 | 45 |
| 2022 August | 22 | 38 | 60 |
| 2022 July | 26 | 49 | 75 |
| 2022 June | 15 | 34 | 49 |
| 2022 May | 24 | 27 | 51 |
| 2022 April | 22 | 31 | 53 |
| 2022 March | 26 | 44 | 70 |
| 2022 February | 18 | 26 | 44 |
| 2022 January | 23 | 36 | 59 |
| 2021 December | 19 | 41 | 60 |
| 2021 November | 17 | 55 | 72 |
| 2021 October | 20 | 59 | 79 |
| 2021 September | 18 | 59 | 77 |
| 2021 August | 16 | 35 | 51 |
| 2021 July | 30 | 28 | 58 |
| 2021 June | 20 | 35 | 55 |
| 2021 May | 22 | 32 | 54 |
| 2021 April | 38 | 75 | 113 |
| 2021 March | 17 | 26 | 43 |
| 2021 February | 16 | 25 | 41 |
| 2021 January | 11 | 15 | 26 |
| 2020 December | 13 | 21 | 34 |
| 2020 November | 13 | 21 | 34 |
| 2020 October | 6 | 7 | 13 |
| 2020 September | 8 | 9 | 17 |
| 2020 August | 12 | 11 | 23 |
| 2020 July | 19 | 15 | 34 |
| 2020 June | 12 | 7 | 19 |
| 2020 May | 14 | 17 | 31 |
| 2020 April | 24 | 19 | 43 |
| 2020 March | 42 | 11 | 53 |
| 2020 February | 67 | 14 | 81 |
| 2020 January | 58 | 16 | 74 |
| 2019 December | 23 | 16 | 39 |
| 2019 November | 32 | 15 | 47 |
| 2019 October | 5 | 15 | 20 |
| 2019 September | 7 | 10 | 17 |
| 2019 August | 15 | 14 | 29 |
| 2019 July | 20 | 16 | 36 |
| 2019 June | 5 | 7 | 12 |
| 2019 May | 20 | 20 | 40 |
| 2019 April | 47 | 23 | 70 |
| 2019 March | 15 | 18 | 33 |
| 2019 February | 13 | 15 | 28 |
| 2019 January | 6 | 15 | 21 |
| 2018 December | 7 | 20 | 27 |
| 2018 November | 20 | 20 | 40 |
| 2018 October | 15 | 12 | 27 |
| 2018 September | 16 | 15 | 31 |
| 2018 May | 3 | 0 | 3 |
| 2018 April | 7 | 4 | 11 |
| 2018 March | 5 | 10 | 15 |
| 2018 February | 6 | 4 | 10 |
| 2018 January | 3 | 10 | 13 |
| 2017 December | 10 | 11 | 21 |
| 2017 November | 7 | 4 | 11 |
| 2017 October | 8 | 14 | 22 |
| 2017 September | 6 | 12 | 18 |
| 2017 August | 8 | 8 | 16 |
| 2017 July | 13 | 9 | 22 |
| 2017 June | 10 | 11 | 21 |
| 2017 May | 8 | 13 | 21 |
| 2017 April | 2 | 6 | 8 |
| 2017 March | 8 | 8 | 16 |
| 2017 February | 5 | 4 | 9 |
| 2017 January | 4 | 4 | 8 |
| 2016 December | 10 | 10 | 20 |
| 2016 November | 11 | 16 | 27 |
| 2016 October | 21 | 10 | 31 |
| 2016 September | 14 | 13 | 27 |
| 2016 August | 19 | 3 | 22 |
| 2016 July | 11 | 4 | 15 |
| 2016 March | 3 | 0 | 3 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 34 | 15 | 49 |
| 2015 September | 33 | 17 | 50 |
| 2015 August | 33 | 11 | 44 |
| 2015 July | 35 | 8 | 43 |
| 2015 June | 32 | 7 | 39 |
| 2015 May | 37 | 9 | 46 |
| 2015 April | 25 | 8 | 33 |
| 2015 March | 30 | 4 | 34 |
| 2015 February | 27 | 3 | 30 |
| 2015 January | 32 | 4 | 36 |
| 2014 December | 41 | 7 | 48 |
| 2014 November | 33 | 4 | 37 |
| 2014 October | 43 | 5 | 48 |
| 2014 September | 28 | 7 | 35 |
| 2014 August | 38 | 7 | 45 |
| 2014 July | 29 | 7 | 36 |
| 2014 June | 52 | 6 | 58 |
| 2014 May | 32 | 13 | 45 |
| 2014 April | 44 | 6 | 50 |
| 2014 March | 45 | 9 | 54 |
| 2014 February | 39 | 11 | 50 |
| 2014 January | 35 | 5 | 40 |
| 2013 December | 35 | 13 | 48 |
| 2013 November | 34 | 8 | 42 |
| 2013 October | 40 | 7 | 47 |
| 2013 September | 39 | 9 | 48 |
| 2013 August | 35 | 7 | 42 |
| 2013 July | 54 | 8 | 62 |
| 2013 June | 41 | 8 | 49 |
| 2013 May | 39 | 7 | 46 |
| 2013 April | 10 | 5 | 15 |
| 2013 March | 7 | 2 | 9 |
Show all
