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Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence
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%)...
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| Published in: | Journal of surgical oncology 2019-09, Vol.120 (4), p.768-778 |
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| container_end_page | 778 |
| container_issue | 4 |
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| container_title | Journal of surgical oncology |
| container_volume | 120 |
| creator | Londero, Francesco Morelli, Angelo Parise, Orlando Grossi, William Crestale, Sara Tetta, Cecilia Johnson, Daniel M. Livi, Ugolino Maessen, Jos G. Gelsomino, Sandro |
| description | 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 |
| doi_str_mv | 10.1002/jso.25635 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6771868</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2275084937</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4435-17fc9b9cb6a216f7165521743f510c74b4155cd31371634bb72e125f108b52d13</originalsourceid><addsrcrecordid>eNp1kUtLxDAYRYMoOj4W_gEpuNFFNc-mcSHI4JMBwcc6pGmqHdqkJu3I_HujVVFBCHyLezjccAHYRfAIQYiP58EdYZYRtgImCIosFVDkq2ASM5xSLuAG2AxhDiEUIqPrYIMgLHhO-ATczZZt96xKY43uXbtMysHX9inphqZ1Vvll0ppehfjG_CS5bjul-8TZJAx-US9UkyhbJt7owXtjtdkGa5Vqgtn5vFvg8eL8YXqVzm4vr6dns1RTSliKeKVFIXSRKYyyiqOMMYw4JRVDUHNaUMSYLgkiMSK0KDg2CLMKwbxguERkC5yO3m4oWlNqY3uvGtn5uo29pVO1_J3Y-lk-uYXMOEd5lkfBwafAu5fBhF62ddCmaZQ1bggSYxZJLD7Q_T_o3A3exu9FijOYU0F4pA5HSnsXgjfVdxkE5ftSMi4lP5aK7N7P9t_k1zQROB6B17oxy_9N8ub-dlS-AYmungE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2275084937</pqid></control><display><type>article</type><title>Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence</title><source>Wiley:Jisc Collections:Wiley Read and Publish Open Access 2024-2025 (reading list)</source><creator>Londero, Francesco ; Morelli, Angelo ; Parise, Orlando ; Grossi, William ; Crestale, Sara ; Tetta, Cecilia ; Johnson, Daniel M. ; Livi, Ugolino ; Maessen, Jos G. ; Gelsomino, Sandro</creator><creatorcontrib>Londero, Francesco ; Morelli, Angelo ; Parise, Orlando ; Grossi, William ; Crestale, Sara ; Tetta, Cecilia ; Johnson, Daniel M. ; Livi, Ugolino ; Maessen, Jos G. ; Gelsomino, Sandro</creatorcontrib><description>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.</description><identifier>ISSN: 0022-4790</identifier><identifier>EISSN: 1096-9098</identifier><identifier>DOI: 10.1002/jso.25635</identifier><identifier>PMID: 31297837</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Aged ; Cancer surgery ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - pathology ; Carcinoma, Non-Small-Cell Lung - surgery ; Female ; Follow-Up Studies ; Humans ; Lung cancer ; lung metastases ; Lung Neoplasms - mortality ; Lung Neoplasms - pathology ; Lung Neoplasms - surgery ; lung resections ; Lymph Node Excision - mortality ; lymphadenectomy ; Male ; Metastasectomy - mortality ; Metastasis ; Middle Aged ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - surgery ; Pneumonectomy - mortality ; Prognosis ; Risk Factors ; Survival Rate</subject><ispartof>Journal of surgical oncology, 2019-09, Vol.120 (4), p.768-778</ispartof><rights>2019 The Authors. Published by Wiley Periodicals, Inc.</rights><rights>2019 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.</rights><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4435-17fc9b9cb6a216f7165521743f510c74b4155cd31371634bb72e125f108b52d13</citedby><cites>FETCH-LOGICAL-c4435-17fc9b9cb6a216f7165521743f510c74b4155cd31371634bb72e125f108b52d13</cites><orcidid>0000-0001-6428-5592 ; 0000-0002-7376-7101 ; 0000-0001-8955-6053 ; 0000-0002-7746-989X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31297837$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Londero, Francesco</creatorcontrib><creatorcontrib>Morelli, Angelo</creatorcontrib><creatorcontrib>Parise, Orlando</creatorcontrib><creatorcontrib>Grossi, William</creatorcontrib><creatorcontrib>Crestale, Sara</creatorcontrib><creatorcontrib>Tetta, Cecilia</creatorcontrib><creatorcontrib>Johnson, Daniel M.</creatorcontrib><creatorcontrib>Livi, Ugolino</creatorcontrib><creatorcontrib>Maessen, Jos G.</creatorcontrib><creatorcontrib>Gelsomino, Sandro</creatorcontrib><title>Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence</title><title>Journal of surgical oncology</title><addtitle>J Surg Oncol</addtitle><description>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.</description><subject>Aged</subject><subject>Cancer surgery</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - pathology</subject><subject>Carcinoma, Non-Small-Cell Lung - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lung cancer</subject><subject>lung metastases</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - surgery</subject><subject>lung resections</subject><subject>Lymph Node Excision - mortality</subject><subject>lymphadenectomy</subject><subject>Male</subject><subject>Metastasectomy - mortality</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Pneumonectomy - mortality</subject><subject>Prognosis</subject><subject>Risk Factors</subject><subject>Survival Rate</subject><issn>0022-4790</issn><issn>1096-9098</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNp1kUtLxDAYRYMoOj4W_gEpuNFFNc-mcSHI4JMBwcc6pGmqHdqkJu3I_HujVVFBCHyLezjccAHYRfAIQYiP58EdYZYRtgImCIosFVDkq2ASM5xSLuAG2AxhDiEUIqPrYIMgLHhO-ATczZZt96xKY43uXbtMysHX9inphqZ1Vvll0ppehfjG_CS5bjul-8TZJAx-US9UkyhbJt7owXtjtdkGa5Vqgtn5vFvg8eL8YXqVzm4vr6dns1RTSliKeKVFIXSRKYyyiqOMMYw4JRVDUHNaUMSYLgkiMSK0KDg2CLMKwbxguERkC5yO3m4oWlNqY3uvGtn5uo29pVO1_J3Y-lk-uYXMOEd5lkfBwafAu5fBhF62ddCmaZQ1bggSYxZJLD7Q_T_o3A3exu9FijOYU0F4pA5HSnsXgjfVdxkE5ftSMi4lP5aK7N7P9t_k1zQROB6B17oxy_9N8ub-dlS-AYmungE</recordid><startdate>20190901</startdate><enddate>20190901</enddate><creator>Londero, Francesco</creator><creator>Morelli, Angelo</creator><creator>Parise, Orlando</creator><creator>Grossi, William</creator><creator>Crestale, Sara</creator><creator>Tetta, Cecilia</creator><creator>Johnson, Daniel M.</creator><creator>Livi, Ugolino</creator><creator>Maessen, Jos G.</creator><creator>Gelsomino, Sandro</creator><general>Wiley Subscription Services, Inc</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6428-5592</orcidid><orcidid>https://orcid.org/0000-0002-7376-7101</orcidid><orcidid>https://orcid.org/0000-0001-8955-6053</orcidid><orcidid>https://orcid.org/0000-0002-7746-989X</orcidid></search><sort><creationdate>20190901</creationdate><title>Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence</title><author>Londero, Francesco ; Morelli, Angelo ; Parise, Orlando ; Grossi, William ; Crestale, Sara ; Tetta, Cecilia ; Johnson, Daniel M. ; Livi, Ugolino ; Maessen, Jos G. ; Gelsomino, Sandro</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4435-17fc9b9cb6a216f7165521743f510c74b4155cd31371634bb72e125f108b52d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Cancer surgery</topic><topic>Carcinoma, Non-Small-Cell Lung - mortality</topic><topic>Carcinoma, Non-Small-Cell Lung - pathology</topic><topic>Carcinoma, Non-Small-Cell Lung - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lung cancer</topic><topic>lung metastases</topic><topic>Lung Neoplasms - mortality</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - surgery</topic><topic>lung resections</topic><topic>Lymph Node Excision - mortality</topic><topic>lymphadenectomy</topic><topic>Male</topic><topic>Metastasectomy - mortality</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Pneumonectomy - mortality</topic><topic>Prognosis</topic><topic>Risk Factors</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Londero, Francesco</creatorcontrib><creatorcontrib>Morelli, Angelo</creatorcontrib><creatorcontrib>Parise, Orlando</creatorcontrib><creatorcontrib>Grossi, William</creatorcontrib><creatorcontrib>Crestale, Sara</creatorcontrib><creatorcontrib>Tetta, Cecilia</creatorcontrib><creatorcontrib>Johnson, Daniel M.</creatorcontrib><creatorcontrib>Livi, Ugolino</creatorcontrib><creatorcontrib>Maessen, Jos G.</creatorcontrib><creatorcontrib>Gelsomino, Sandro</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Londero, Francesco</au><au>Morelli, Angelo</au><au>Parise, Orlando</au><au>Grossi, William</au><au>Crestale, Sara</au><au>Tetta, Cecilia</au><au>Johnson, Daniel M.</au><au>Livi, Ugolino</au><au>Maessen, Jos G.</au><au>Gelsomino, Sandro</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence</atitle><jtitle>Journal of surgical oncology</jtitle><addtitle>J Surg Oncol</addtitle><date>2019-09-01</date><risdate>2019</risdate><volume>120</volume><issue>4</issue><spage>768</spage><epage>778</epage><pages>768-778</pages><issn>0022-4790</issn><eissn>1096-9098</eissn><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.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31297837</pmid><doi>10.1002/jso.25635</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-6428-5592</orcidid><orcidid>https://orcid.org/0000-0002-7376-7101</orcidid><orcidid>https://orcid.org/0000-0001-8955-6053</orcidid><orcidid>https://orcid.org/0000-0002-7746-989X</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Cancer surgery Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - pathology Carcinoma, Non-Small-Cell Lung - surgery Female Follow-Up Studies Humans Lung cancer lung metastases Lung Neoplasms - mortality Lung Neoplasms - pathology Lung Neoplasms - surgery lung resections Lymph Node Excision - mortality lymphadenectomy Male Metastasectomy - mortality Metastasis Middle Aged Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Pneumonectomy - mortality Prognosis Risk Factors Survival Rate |
| title | Lymphadenectomy during pulmonary metastasectomy: Impact on survival and recurrence |
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