Abstract: Introduction: Metastasectomy is the most frequent surgical resection undertaken by thoracic surgeons, being the lung is the second common site of metastases. Pulmonary metastasectomy is currently indicated for patients with the following criteria: primary tumor controlled, possibility of complete resection verified by computed tomography (CT) of the chest, pulmonary function and performance status compatible with the proposed lung resection, and lack of another available treatment that would be more effective than the surgical procedure.
Material and Methods: This is a prospective study conducted in the Department of Surgical Oncology at Kidwai Memorial Institute of Oncology from July 2018 to December 2019. all patients who underwent pulmonary metastasectomy were included in this analysis. Individual patient data were obtained from the case records. A total of 60 patient records were obtained, of that only 47 cases were taken analysis. Patients who underwent planned sequential or staged metastasectomies were considered to have single metastasectomy and redo surgery.
Results: A total of 60 patients underwent pulmonary metastasectomy, of which only 47 patient records were taken for analysis. Overall there were 27 males (57.4%), and the mean age was 32 years (median 29 years, range 14-65 years). Sarcomas, both soft tissue and osteogenic constituted 64 % of pulmonary metastasectomies (osteosarcoma – 34%, sarcoma – 30%), and the rest comprised of epithelial tumors (31%, which includes various subsites like breast, parotid, cervix, endometrium, testis and rectum [13 %]) and other sites (2 patients 4%, Giant cell tumor of bone and choriocarcinoma).
Conclusions: Good prognostic variables like increasing DFI (> 1 year), ability to do R0 resection, solitary metastasis, size of the lesion less than 1 cm, and absence of mediastinal nodal positivity showed a trend towards improved survival. Good prognostic group selected on the basis of the risk factors like completely resected lesions, DFI and number of metastases show a difference in survival between good risk and poor risk groups (87% and 64% at 36 months).
