The Role Of Thoracic Surgery In Treatment Of Pulmonary Metastasis



Year of publication 2009
Type Conference abstract
MU Faculty or unit

Faculty of Medicine

Description Background The problem of surgical treatment of pulmonary metastasis is still alive, it is accepted in the world as a curative way of treatment of pulmonary metastasis. But the problem lies in the Czech Republic that only a few oncologists accept it as one of the most effective ways of treatment. Prognostic factors for pulmonary metastasectomies are complete resection, disease free interval, the amount and size of the metastasis, tumor double time, histology of the primary tumor and biologic aggressiveness of the tumor. Methods The effect of the surgery is based on exact diagnostic investigation (X-ray, HRCT, PET-CT) and on the proper selection of patients based on the contol of the primary tumor, no metastasis in other localizations, the possibility of complete resection, good cardiopulmonal condition of the patient, no other better way of treatment and low-operative risk. As contraindications are mostly considered low pulmonary function, impossibility of complete resection and the presence of many tiny metastasis. According to the size, number and side is chosen the right access to the pulmonary cavity and the proper surgery is performed. The importance of mediastinal lymphadenectomy was not defined yet. The presence of positive lymphnodes is not a good prognostic factor for long-time survival rate. Results The authors will present the results of pulmonary metastasectomies in the last ten years on over 100 patients performed in our department. Most of the surgeries were performed by atypic resection with safety margin, also some lobectomies and enclueations. No pneumonectomy was performed. Mediastinal lymphadenectomy was performed at carcinomas. Conclusions Pulmonary metastasectomy can be when performed by a experienced surgeon and after an exact indication, a way of secure, effective and potentially curative treatment .

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