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Metastasectomy - Top 30 Publications

The Efficacy of Wide Resection for Musculoskeletal Metastatic Lesions of Renal Cell Carcinoma.

This study evaluated the outcome of wide resection for metastatic renal cell carcinoma (RCC) to the bone or soft tissue.

Autologous fat tissue grafting improves pulmonary healing after laser metastasectomy.

Extensive clinical experience has demonstrated the potential usefulness of autologous fat tissue (AFT) graft in tissue reconstruction, repair or regeneration. In the present study, we evaluated the feasibility and safety of AFT in the repair of surgically injured lung surface.

Is Repeat Pulmonary Metastasectomy Indicated for Soft Tissue Sarcoma?

Because recurrence is high after pulmonary metastasectomy (PM) for soft tissue sarcoma (STS), repeat PM is commonly performed. Our objective was to define the selection criteria for repeat PM among patients experiencing recurrence and to identify factors associated with survival.

Surgical Treatment for Pulmonary Metastasis of Pancreatic Ductal Adenocarcinoma: Study of 12 Cases.

Few studies have reported results with pulmonary metastasectomy for pancreatic ductal adenocarcinoma (PDAC), probably because of their extremely poor outcomes. The aim of this study was to review our institutional experience and analyze the outcomes of pulmonary metastasectomy for PDAC.

Ablation of Musculoskeletal Metastases.

The purpose of this article is to summarize the evidence supporting thermal ablation of musculoskeletal metastases on the basis of clinical application and to describe an approach to percutaneous ablative treatment, including patient workup, procedural strategy and techniques, and postablation follow-up.

Multimodal Therapy of Squamous Cell Carcinoma of the Anus With Distant Metastasis: A Single-Institution Experience.

Because of the rarity of the condition, studies concerning the management of patients with squamous cell carcinoma of the anus with distant metastasis are scarce. The available studies indicate poor outcomes with exclusive chemotherapy.

Surgical Outcome and Prognostic Stratification for Pulmonary Metastasis From Colorectal Cancer.

This study investigated recent clinical outcomes and prognostic factors of metastasectomy for pulmonary metastasis (PM) from colorectal cancer.

Survival after initial lung metastasectomy for metastatic colorectal cancer in the modern chemotherapeutic era.

A clear survival benefit has been reported for lung metastasectomy for colorectal cancer, and several clinicopathological prognostic factors have been proposed in the past. However, clinical advances, such as chemotherapy and radiographic imaging, should have improved patient outcome and may have altered prognosticators. This study aimed to assess patient survival and determine prognostic factors for survival and recurrence in patients who underwent initial lung metastasectomy for colorectal cancer in the modern clinical era.

Surgical Treatment for Pulmonary Metastasis of Head and Neck Cancer: Study of 58 Cases.

Although the number of surgeries performed for pulmonary metastasis of head and neck cancer has been increasing, there have been few reports of the surgical effectiveness. We collected the data of surgeries performed in our facility in order to discuss the surgical performance and indication.

Metastatic Intracerebral Plasmacytoma Treated with Radiation and Thalidomide, Dexamethasone with Cyclophosphamide Chemotherapy.

Intracerebral plasmacytoma is an extremely rare disease for which no treatment protocol has been established. The authors present a case of metastatic intracerebral plasmacytoma that was partially resected and treated with radiation therapy. For tumor recurrence, a combination chemotherapy regimen was initiated. A 48-year-old male patient presented with dizziness and memory loss. Conventional magnetic resonance imaging (MRI) of the brain revealed a multilobulated mass with enhancing cystic and solid components measuring 7 × 7 × 6 cm in the left frontal lobe. The patient had undergone subtotal gastrectomy and transverse colectomy 8 years before admission and had been diagnosed with extraosseous plasmacytoma. At the time of the current presentation, the patient underwent craniotomy for the parenchymal lesion. Partial tumor resection was performed. Histologic and immunohistochemical examinations confirmed the diagnosis of plasmacytoma. Fractionated radiotherapy was administered, and no enhancing mass was observed on follow-up MRI. One year after radiotherapy, tumor recurrence was observed in a different area of the cerebral parenchyma. Combination thalidomide, dexamethasone, and cyclophosphamide chemotherapy was administered. After three cycles of chemotherapy, the tumor was well controlled on MRI. Hereafter, two more times of tumor recurrence occurred in the other sites of the cerebral parenchyma, but with chemoradiation therapy, the tumor was well suppressed. The findings of this case suggest that the cerebral parenchyma can be one of the metastatic sites for extraosseous plasmacytoma. In addition, combination chemotherapy with thalidomide, dexamethasone, and cyclophosphamide may be a useful treatment option for intracerebral plasmacytoma.

Does perioperative chemotherapy improve survival in patients with resectable lung metastases of colorectal cancer?

A best evidence topic was constructed according to a structured protocol. The question addressed was whether the administration of perioperative chemotherapy (CT) is effective in improving survival in patients with resectable lung metastases of colorectal cancer (CRC). Of the 44 papers found using a report search, 6 investigated the effect of perioperative CT (adjuvant-CT, preoperative-CT or both) on outcomes in patients undergoing lung metastasectomy for CRC. These 6 studies presented the best evidence to answer the clinical question. The authors, journal, date and country of publication, study type, group studied, relevant outcomes and results of these papers are given. Overall, none of the studies were successful in demonstrating that CT had an independent effect on overall survival in patients undergoing lung resection surgery for CRC metastasis. Indeed, beneficial outcomes have been shown in particular sub-groups of patients: multiple metastases, metachronous lung metastasis, low-risk patients, particular molecular marker expression and oxaliplatin-based regimen. All the studies indicated a benefit in disease-free survival or progression-free survival. Administration of tailored perioperative CT might be effective after an accurate patient selection. We conclude that the current evidence does not support the administration of unselective perioperative CT in patients with resectable lung metastases of colorectal cancer.

Surgical management of lung metastases.

Management of pulmonary metastases has evolved considerably over the last few decades but is still controversial. The surgical management of lung metastases is outlined, discussing the preoperative management, indications for surgery, the surgical approach and outcomes according to the primary histology.

Video-assisted thoracic surgery mediastinal germ cell metastasis resection.

Thoracoscopy can be safely used for dissection of masses in the visceral mediastinum. We report the case of a 31-year-old man affected by metastatic germ cell tumour and successfully treated with a 3-port posterior approach video-assisted thoracic surgery.

Ultrasonography During Surgery to Approach Cerebral Metastases: Effect on Karnofsky Index Scores and Tumor Volume.

The goals of treating a cerebral metastasis (CM) are to achieve local control of the disease and to improve patient quality of life. The aim of this study was to analyze the effect of conventional surgery supported by intraoperative ultrasound (IOUS) to approach a CM. To perform this analysis, we determined the postoperative Karnofsky Performance Status Scale (KPS) scores and tumor resection grades.

Prognostic factors for overall survival after lung metastasectomy in renal cell cancer patients: A systematic review and meta-analysis.

Pulmonary metastasis of Renal cell carcinomas (RCC) is usually considered as a systemic disease. However, some studies revealed potential survival benefits of pulmonary metastasectomies for such patients. The aim of this study was to conduct a systematic review and meta-analysis to assess the prognostic factors for pulmonary metastasectomy of RCC patients.

The impact of pulmonary metastasectomy in patients with previously resected colorectal cancer liver metastases.

40-50% of patients with colorectal cancer (CRC) will develop liver metastases (CRLM) during the course of the disease. One third of these patients will additionally develop pulmonary metastases.

Outcome after Surgery for Metastases to the Pelvic Bone: A Single Institutional Experience.

The pelvic bone is the most common site of bone metastases following the axial skeleton. Surgery on the pelvic bone is a demanding procedure. Few studies have been published on the surgical outcomes of metastasis to the pelvic bone with only small numbers of patients involved. This study sought to analyze the complications, local progression and survival after surgery for metastasis to the pelvic bone on a larger cohort of patients.

A dosimetric comparison between CyberKnife and tomotherapy treatment plans for single brain metastasis.

Radiosurgery (RS) is a well-established treatment in selected patients with brain metastasis. The aim of this study is to compare the differences between CyberKnife (CK) and TomoTherapy (HT) treatment plans of RS of single brain metastasis (BM) to define when HT should be used in cases beyond Cyberknife-when both systems are readily available for the radiation oncologist.

Overall survival and the response to radiotherapy among molecular subtypes of breast cancer brain metastases treated with targeted therapies.

The current study was conducted to investigate survival and the response to radiotherapy among patients with molecular subtypes of breast cancer brain metastases treated with or without targeted therapies.

Video-Assisted Laser Resection of Lung Metastases-Feasibility of a New Surgical Technique.

Background Our pilot study describes our initial experience to do a laser resection of lung metastases under video-assisted thoracoscopic control via a minithoracotomy. With this approach, if needed, mediastinal lymphadenectomy is also possible. Methods In this study, 15 patients (11 men and 4 women, mean age: 60 years) with resectable lung metastases of different solid primary tumors (colorectal cancer in seven patients, melanoma in three patients, renal cell carcinoma in two patients, and one each with oropharyngeal cancer, breast cancer, and seminoma) were included. An anterior minithoracotomy incision (approximately 5-7 cm length) was created in the fifth intercostal space and a soft tissue retractor (Alexis Protector; Applied Medical) was positioned. Two additional working ports were inserted. The entire lung was palpated via the minithoracotomy. All detected lung metastases were removed under thoracoscopic control. Nonanatomic resections were performed using a diode-pumped neodymium-doped yttrium aluminium garnet laser (LIMAX120; KLS Martin GmbH & Co KG) with a laser power of 80 W in a noncontact modus. Deeper parenchymal lesions were sutured. Results A total of 29 lung metastases up to 30 mm in size were resected and all metastases diagnosed on preoperative imaging were detected. All diagnosed lung metastases were completely resected (R0). The median operation time was 102 (range: 85-120) minutes. Median blood loss was 47.6 mL and no postoperative complications occurred. Neither local recurrences nor new lung metastases were observed within 6 months after the procedures. Conclusion Video-assisted laser resection of lung metastases is safe, effective, and fulfills the requirements of modern lung metastases surgery.

Lymphadenectomy in Pulmonary Metastasectomy: For Diagnostic Purpose or Therapeutic Effect?

C-reactive protein (CRP) as a prognostic factor for colorectal cancer after surgical resection of pulmonary metastases.

Pulmonary metastases occur in up to 25% of colorectal cancer (CRC) patients. Many studies have reported that pulmonary metastasectomy might increase 5-year survival of these patients. The aim of this study was to describe our experience with pulmonary metastasectomy for metastatic colorectal cancer and to explore the prognostic value of serum C-reactive protein (CRP) and other factors.

Repeat resection for recurrent pulmonary metastasis of colorectal cancer.

Resection of recurrent lung metastases from colorectal cancer is not completely investigated. We analyzed overall survival and prognosticators after metastasectomy.

Preoperative evaluation of pancreatic ductal adenocarcinoma with synchronous liver metastasis: Diagnosis and assessment of unresectability.

To identify predictors for synchronous liver metastasis from resectable pancreatic ductal adenocarcinoma (PDAC) and assess unresectability of synchronous liver metastasis.

Parenchymal-sparing Hepatectomy as the New Doctrine in the Treatment of Liver-metastatic Colorectal Disease: Beyond Oncological Outcomes.

Colorectal cancer is one of the leading causes of mortality in the Western world. Half of patients with colorectal cancer will develop liver-metastatic (CLM) disease, with fewer than 30% having surgically resectable disease at diagnosis. It is well established in the literature that major hepatectomy offers a high rate of R0 resection, however, with concommitant increased rates of mortality and morbidity. Emerging literature during the past two decades has demonstrated the potential superiority of parenchymal-sparing hepatectomy (PSH) in treating CLM disease in terms of oncological outcomes, survival and re-operation in cases of recurrence (salvageability). To date, no data regarding the evaluation of quality of life and cost after PSH have been published. PSH seems to be correlated with less mortality and morbidity, which can be translated in lower re-admission rates, better quality of life and, therefore, reduced relevant cost. Prospective studies and clinical trials evaluating the multiple beneficial role of a PSH surgical strategy in CLM disease are mandatory to support or reject the emerging belief that PSH could be the gold standard of treatment of CLM disease.

Operative morbidity and survival following hepatectomy for colorectal liver metastasis in octogenarians: a contemporary case matched series.

Clinical outcomes of octogenarians undergoing hepatectomy for colorectal liver metastases (CRLM) are poorly characterized. The current study evaluated operative morbidity, mortality and survival outcomes among a contemporary cohort of octogenarians.

Histology is a Prognostic Indicator After Pulmonary Metastasectomy from Renal Cell Carcinoma.

There are only a few detailed reports concerning the prognosticators following surgical resection of pulmonary metastases (PMs) from renal cell carcinoma (RCC). We investigated the prognosis of patients with RCC PMs undergoing pulmonary metastasectomy and identified prognostic factors in a multi-institutional retrospective study.

Metastasectomy in cutaneous melanoma.

Metastasectomy remains the only treatment in malignant melanoma to offer complete pathologic response within a few days of in-hospital stay. It has been historically associated with the highest survival rates in the literature reported for patients of this stage. However, only a minority of patients are amenable to curative resection of distant metastatic disease. This patient group exhibit slow growing oligometastases as indicated by: a. Long disease free interval after treatment of their primary tumours and b. An exhaustive preoperative work up with the use of PET/CT and MRI scans. Only complete resection of all metastases is associated with long term survival and debulking should not be attempted. Metastasectomy has also been shown to offer significant palliation in cases of gastrointestinal bleeding or obstruction. The timing and the sequencing of surgery in the modern multimodal targeted treatment of melanoma is still unclear and warrants further investigation.

Planned Treatment of Advanced Metastatic Disease with Completion Ablation After Hepatic Resection.

The aim of this study is to describe a modified treatment strategy with image-guided percutaneous ablation after hepatic resection as a completion method to surgical eradication of liver metastases ("completion ablation [CA]").

Liver metastases of malignant melanoma - utility of resection or radiofrequency ablation.

Incidence of cutaneous and uveal forms of malignant melanoma (MM) has increased significantly in the population in the last years. Biological behavior of both these forms of MM is different and is associated with the development of liver metastases. The prognosis of patients with MM liver metastases is generally poor. The authors seek to consider the sense and the possibilities of surgical treatment of MM liver metastases.