Abstract
Background
Lung metastasectomy has become an effective treatment for selected patients with colorectal cancer, renal cancer, and other malignancies; however, limited experience has been reported regarding pulmonary metastasectomy for esophageal carcinoma. We reviewed 23 patients with esophageal cancer who underwent pulmonary metastasectomy and investigated their long-term prognosis and prognostic factors.
Methods
A total of 23 patients who underwent 30 curative pulmonary metastasectomies at Toranomon Hospital, Japan, between 2001 and 2011 were included. Four patients underwent repeated metastasectomy. The overall survival rate was examined by the Kaplan–Meier method and various characteristics were assessed by univariate analysis to identify prognostic factors.
Results
The overall 1-, 3-, and 5-year survival rate was 82.6, 46, and 34.1 %, respectively. Median follow-up was 37.4 months (range 1–114 months). Univariate analysis revealed a history of extrapulmonary metastases before pulmonary metastasectomy, poorly differentiated primary esophageal carcinoma, and short disease-free interval (DFI) as unfavorable prognostic factors. Five patients who underwent repeated metastasectomy for recurrent pulmonary metastases survived a mean 58 months (range 24–114 months). The other patients survived a mean 29.4 months (range 1–109 months).
Conclusions
Pulmonary resection for lung metastases from esophageal carcinoma should be considered in selected patients, and repeated metastasectomy should be encouraged. Extrapulmonary metastases before pulmonary metastasectomy, poor differentiation of primary esophageal carcinoma, and short DFI are unfavorable prognostic factors. Due to poor prognosis, metastasectomy in patients with these factors should be more carefully considered before being indicated.
Similar content being viewed by others
References
Pastorino U, et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg. 1997;113:37–49.
Lin B, et al. Pulmonary resection for colorectal cancer metastases: duration between cancer onset and lung metastasis as an important prognostic factor. Ann Surg Oncol. 2009;16:1026–32.
Yedibela S, et al. Surgical management of pulmonary metastases from colorectal cancer in 153 patients. Ann Surg Oncol. 2006;13:1538–44.
Hauke W, et al. Does surgical resection of pulmonary metastases of head and neck cancer improve survival? Ann Surg Oncol 2008;15:2915–26.
Bölükbas S, et al. The influence of the primary tumor on the long-term results of pulmonary metastasectomy for metastatic renal cell carcinoma. Thorac Cardiovasc Surg. 2012;60:390–7.
Bhansali M, et al. Pattern of recurrence after extended radical esophagectomy with three-field lymph node dissection for squamous cell carcinoma in the thoracic esophagus. World J Surg 2000;87:1426–33.
Ichikawa H, et al. Operative treatment for metachronous pulmonary metastasis from esophageal carcinoma. Surgery. 2011;149:164–70.
Shiono S, et al. Disease-free interval length correlates to prognosis of patients who underwent metastasectomy for esophageal lung metastases. J Thorac Oncol. 2008;3:1046–9.
Kozu Y, et al. Surgical treatment for pulmonary metastases from esophageal carcinoma after definitive chemoradiationtherapy: experience from single institution. J Cardiothorac Surg. 2011;6:135.
Chen F, et al. Pulmonary resection for metastasis from esophageal carcinoma. Interact Cardiovasc Thorac Surg. 2008;7:809–12.
Morita M, et al. Advances in esophageal cancer surgery in Japan: an analysis of 1000 consecutive patients treated at a single institute. Surgery. 2008;143:499–508.
Makowiec F, et al. Improved long-term survival after esophagectomy for esophageal cancer: influence of epidemiologic shift and neoadjuvant therapy. J Gastrointest Surg. 2013;17:1193–201.
Blom RL, et al. Survival after recurrent esophageal carcinoma has not improved over the past 18 years. Ann Surg Oncol. 2013;20:2693–98.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kobayashi, N., Kohno, T., Haruta, S. et al. Pulmonary Metastasectomy Secondary to Esophageal Carcinoma: Long-Term Survival and Prognostic Factors. Ann Surg Oncol 21 (Suppl 3), 365–369 (2014). https://doi.org/10.1245/s10434-014-3677-7
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1245/s10434-014-3677-7