Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence

Londero, Francesco; Morelli, Angelo; Parise, Orlando; Grossi, William; Crestale, Sara; Tetta, Cecilia; Johnson, Daniel M.; Livi, Ugolino; Maessen, Jos G. and Gelsomino, Sandro (2019). Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence. Journal of Surgical Oncology, 120(4) pp. 768–778.

DOI: https://doi.org/10.1002/jso.25635

Abstract

Background and Objectives: Lymphadenectomy during pulmonary metastasectomy (PM) is widely carried out. We assessed the potential benefit on patient survival and tumor recurrence of this practice.

Methods: One hundred eighty‐one patients undergoing a first PM were studied. Eighty‐six patients (47.5%) underwent lymphadenectomy (L+ group) whereas 95 (52.5%) did not undergo nodal harvesting (L−group). Main outcomes were overall survival (OS) and disease‐free survival (DFS). Median follow‐up was 25 months (interquartile range [IQR], 13‐49).

Results: At follow‐up 84 patients (46.4%) died, whereas 97 (53.6%) were still alive with recurrence in 78 patients (43%). There was no difference in 5‐year survival (L+ 30.0% vs L− 43.2%; P = .87) or in the 5‐year cumulative incidence of recurrence (L + 63.2% vs L−80%; P = .07) between the two groups. Multivariable analysis indicated that disease‐free interval (DFI) less than 29 months (P < .001) and lung comorbidities (P = .003) were significant predictors of death. Metastases from non‐small–cell lung cancer increased the risk of lung comorbidities by a factor of 19.8, whereas the risk of DFI less than 29 months was increased nearly 11‐fold. Competing risk regression identified multiple metastases (P = .004), head/neck primary tumor (P = .009), and age less than 67 years (P = .024) as independent risk factors for recurrence.

Conclusion: Associated lymphadenectomy showed not to give any additional advantage in terms of survival and recurrence after PM.

Viewing alternatives

Look up in Google Scholar

Download history

Metrics

Public Attention

Altmetrics from Altmetric

Number of Citations

Citations from Dimensions

Item Actions

Export

About

CORE (COnnecting REpositories)

Recommendations