Pleuropneumonectomy as Salvage Therapy in Children Suffering from Primary or Metastatic Sarcomas with Pleural Localizations

Cancers

Wim Jan P. van Boven¹  Niels van der Kaaij²  Pierre-Yves Mure³  Frédéric Hameury³  Franck Chotel³  François Tronc³  Clara Libbrecht⁴  Perrine Marec-Berard⁴  Mathilde Eymery⁴  Lianne M. Haveman⁵  Marc H. W. Wijnen⁵ 

[1] Department of Cardiothoracic Surgery, Amsterdam University Center, Location AMC, 1105 AZ Amsterdam, The Netherlands;Department of Cardiothoracic Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands;Department of Pediatric Surgery, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Claude Bernard University, 69677 Bron, France;Institute of Hematology and Pediatric Oncology, 69008 Lyon, France;Princess Maxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands;

关键词: pleuropneumonectomy;    pediatric;    sarcoma;    quality of life;    outcome;   

DOI  :  10.3390/cancers13153655

来源: DOAJ

【 摘 要 】

Pediatric sarcoma patients with pleuropulmonary lesions have a dismal prognosis because the impossibility to obtain local control. The aim of this study was to determine if pleuropneumonectomy (PP) could be a therapeutic option. We retrospectively reviewed nine patients who underwent salvage PP for pleuropulmonary localization of primary localized sarcoma or metastatic recurrence. Surgery and complications were analyzed, pulmonary function tests were conducted, and quality of life was determined with EORTC-QLQ-C30 questionnaire. At the time of PP age was between 9–17 years. Underlying disease included metastatic osteosarcoma (n = 5), Ewing sarcoma (two metastatic, one primary), and one primary undifferentiated sarcoma. Early complications occurred in three patients. Mean postoperative hospitalization stay was 14.5 days. Pulmonary function test showed 19–66% reduction of total lung capacity which led to mild exercise intolerance but did not affect daily life. Four patients died of multi-metastatic relapse <14 months after PP, one patient had a local recurrence, and four patients are in complete remission between 1.5 and 12 years after PP. In conclusion, in this small patient group treated with a pleuropneumonectomy for primary or metastatic lesions, outcome is variable; however, this extended surgical technique was generally quite well tolerated. Postoperative lung function seems well preserved, and it seems to lead to at least an extension of life with good quality and therefor can be considered as salvage therapy.

【 授权许可】

Unknown