IRLM
Sottotitolo
Registro Internazionale dei pazienti sottoposti a resezione di metastasi polmonari.
Disegno Studio
Retrospettivo
Centro
Multicentrico
Anno di inizio
1988
Ruolo di Ugo Pastorino
Coordinator
Numero di pazienti
5206
Stato
Concluso
Anno di conclusione
1997
Funding Agencies
CNR
Sinossi
The International Registry of Lung Metastases was established in 1991 to assess the long-term results of pulmonary metastasectomy.
The Registry has accrued 5,206 cases of lung metastasectomy, from18 departments of thoracic surgery in Europe (13), United States (4) and Canada. Of these patients, 4,572 (88%) underwent complete surgical resection. The primary tumour was epithelial in 2260 cases, sarcoma in 2173, germ cell in 363 and melanoma in 328; the disease-free interval (DFI) was 0-11 months in 2199 cases,12-35 months in1857 and 36+ months in1620; single metastases accounted for 2383 cases whilst 2726 had multiple lesions. Mean follow-up was 46 mos. Analysis was performed by Kaplan-Meier estimates of survival, relative risks of death, and multivariate Cox model.
The actuarial survival after complete metastasectomy was 36% at 5 years, 26% at 10 years and 22% at 15 years (median 35 months ); the corresponding values for incomplete resection were 13% at 5 years and 7% at 10 years (median 15 months). Among complete resections, the 5-year survival was 33% for patients with DFI of 0-11 months and 45% for DFI of 36+ months ; 43% for single lesion and 27% for 4+ lesions. Multivariate analysis showed a better prognosis for germ cell tumours, DFI of 36+ months and single metastases.
These results confirm that lung metastasectomy is a safe and potentially curative procedure. Resectability, DFI and number of metastases allowed to design a simple system of classification valid for different tumour types.
Pubblicazioni
