Ressecção cirúrgica de metástases pulmonares: estudo prospectivo em 182 pacientes

Abstract

PURPOSE: The present study evaluates the results of surgical treatment of lung metastases, as well as attempts to identify subgroups of patients who would benefit the most from the operation. CASE AND METHODS: This is a prospective analysis of patients with history of neoplasia, submitted to resection of pulmonary nodules, with the diagnosis or suspicion of metastases. The 182 patients were operated upon through a lateral thoracotomy. RESULTS: The patients submitted to pulmonary resection for suspected metastases showed no malignant tissue in 34 patients (18.6%), and in six patients (3.2%) were diagnosed a second lung primary tumor. Overall survival of the patients was 28% at 56 months, and disease-free survival was 9%. Multivariate analysis showed that disease free interval (p=0.002), complete resection (p=0.039), and number of malignant nodules resected (p=0.016) significantly affected overall survival. Disease-free survival was affected only by complete resection (p=0.0001) and number of malignant nodules resected (p=0.004). CONCLUSION: Resection of pulmonary metastasis improve survival in a selected group of patients. More studies are necessary to define the value of other therapies in the results of survival in resected pulmonary metastasis.