ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The prognostic effect of lymph node dissection in secondary lung tumor metastasectomies
Salih Duman1, Berk Çimenoğlu2, Melike Ülker1, Melek Ağkoç1, Suat Erus3, Berker Özkan1, Murat Kara1, Alper Toker4
1Department of Thoracic Surgery, Istanbul University Istanbul Faculty of Medicine, Istanbul, Türkiye
2Department of Thoracic Surgery, Health Sciences University, Kartal Dr. Lütfi Kırdar Training and Research Hospital, Istanbul, Türkiye
3Department of Thoracic Surgery, Koç University, Istanbul, Türkiye
4Department of Cardiovascular and Thoracic Surgery, West Virginia University Heart and Vascular Institute, West Virginia, USA
DOI : 10.5606/tgkdc.dergisi.2022.21402
Background: In this study, we aimed to investigate the prognostic effect of lymph node dissection in secondary lung tumor metastasectomies.

Methods: Between January 2001 and December 2015, a total of 201 patients (122 males, 79 females; mean age: of 41.4±19.2 years; range, 3 to 79 years) who had pulmonary metastasectomy due to colorectal carcinoma, renal cell carcinoma, and soft tissue - skeletal sarcomas were retrospectively analyzed. The clinicopathological features of the patients, overall survival, and complication rates according to the presence of lymph node dissection were evaluated.

Results: The most common histopathological subtype was a sarcoma in 118 (58.7%) patients, followed by colorectal carcinoma in 63 (31.3%) patients, and renal cell carcinoma in 20 (10%) patients. A total of 88 (43.7%) patients underwent systematic lymph node dissection with pulmonary metastasectomy. The mean overall survival of patients with and without lymph node dissection were 49±5.9 (95% confidence interval 37.3-60.6) and 26±4.4 (95% confidence interval 17.2-34.7) months, respectively (p=0.003). The five-year survival rates in colorectal carcinoma, renal cell carcinoma, and sarcoma were 52%, 30%, and 23%, respectively (p=0.002). Locoregional recurrences occurred in 15 (35.7%) patients in the lymph node dissection group and in 23 (60.5%) patients in the non-lymph node dissection group (p=0.026). Lymph node dissection did not show a significant relationship regarding to postoperative complications (p=0.09).

Conclusion: Lymph node dissection following pulmonary metastasectomy may improve the overall survival and reduce locoregional recurrence, without any increase in morbidity and mortality.

Keywords : Colorectal carcinoma, lymph node dissection, pulmonary metastasectomy, renal cell carcinoma, sarcoma
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