Metachronous pulmonary metastasis after radical esophagectomy for esophageal cancer: prognosis and outcome

Journal of Cardiothoracic Surgery

Kayo Yoshida²  Mamiko Takii²  Katsunobu Sakurai²  Masashi Takemura¹ 

[1] Department of Upper Gastrointestinal Surgery, Hyogo College of Medicine, 1-1, Mucogawa-machi, Nishinomiya City, Hyogo 663-8501, Japan;Department of Gastrointestinal Surgery, Osaka City General Hospital, 1-8-20, Nagasu Nishidori, Amagasaki City, Hyogo, 660-0807, Japan

关键词: Metastasectomy;    Esophageal cancer;    Metachronous pulmonary metastasis;   

Others  :  1152735
DOI  :  10.1186/1749-8090-7-103

 received in 2012-07-11, accepted in 2012-09-25,  发布年份 2012

【 摘 要 】

Background

Few reports discuss the outcome of pulmonary metastasis after radical esophagectomy for esophageal cancer. To clarify the data from such cases, we conducted a retrospective study on the clinical outcome of patients who developed pulmonary metastasis after undergoing radical esophagectomy.

Methods

We retrospectively reviewed the prognosis and clinical outcome of 25 patients who developed metachronous pulmonary metastasis after esophagectomy for esophageal cancer.

Results

The site of recurrence was pulmonary without extrapulmonary metastasis in 14 patients and extrapulmonary metastasis was observed in 11. Nineteen patients had multiple pulmonary metastasis and 6 had solitary pulmonary metastasis. Twenty-four of patients underwent systemic chemotherapy during initial treatment for metastatic lesions. Pulmonary metastasectomy was indicated in 5 patients with solitary metastasis. The actual 1-, 2- and 4-year survival rates were 60%, 36% and 27%, respectively. Gender, operative procedure, and postoperative morbidity were not significant prognostic factors. However, pathological staging of primary esophageal cancer was a significant prognostic factor. Survival was significantly worse in patients who did not undergo resection than in those who did. The number of pulmonary metastasis, complicated extrapulmonary metastasis and the time of recurrence were also significant prognostic factors.

Conclusions

Multiple pulmonary metastases or complicated extrapulmonary metastasis were unfavorable prognostic factors for patients with pulmonary metastasis arising from esophageal cancer. Although, surgical intervention is not recommended in such cases, metastasectomy is an acceptable choice of treatment for solitary pulmonary metastasis.

【 授权许可】

   
2012 Takemura et al.; licensee BioMed Central Ltd.

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