演題

IS-9-2

Optimal starting point for calculation of survival for patients with pulmonary metastasectomy:Why has it not yet been unified?

[演者] 上吉原 光宏:1
[著者] 井貝 仁:1, 伊部 崇史:1, 河谷 菜津子:1, 尾林 海:2, 中澤 世識:2, 渥實 潤:2, 大瀧 容一:2, 永島 宗晃:2, 懸川 誠一:2, 菅野 雅之:2, 清水 公裕:2, 竹吉 泉:2
1:前橋赤十字病院呼吸器外科, 2:群馬大学臓器病態外科

Purpose: Previously published papers on metastatic lung cancer have used various starting points for calculation of survival, including the times of primary tumor resection, the first pulmonary metastasectomy, and the final pulmonary metastasectomy. The aim of this study was to identify differences in prognostic factors according to the starting point of survival calculation.Methods: In total, 202 consecutive patients underwent surgical resection for pulmonary metastases from 1998 to 2013. Of these, 146 (excluding overlapping cases) underwent pulmonary metastasectomy. The patients comprised 81 males and 65 females with a mean age of 65 years. We examined survival after resection in patients with pulmonary metastases (Group M) and primary tumors (Group P). The prognostic influence of variables on survival was analyzed.Results: Pulmonary metastases were located in the colon or rectum (n = 79); urinary tract (n = 17); uterus, ovary, or testis (n = 14); head or neck (n = 14); and other organs (n = 22). The 5-year survival rate was 76.7% in Group P and 62.0% in Group M. The significant prognostic factor in Group P was the disease-free interval (>1 and >2 years), and that in Group M was the maximum tumor diameter. Interestingly, however, multivariate analysis showed that the statistically significant prognostic factors (age and nodule diameter) were identical between the two groups (Table).Conclusions: Unifying the survival period from the time of primary tumor resection may resolve variances in survival, because pulmonary metastasectomy is only one option among several treatments for primary tumor.
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