Xie Huawei,Zhang Weiling,Liu Gang,et al.Surgical treatment of pulmonary metastases in pediatric solid tumors: a report of 80 cases[J].Journal of Clinical Pediatric Surgery,,19():415-419.[doi:10.3969/j.issn.1671-6353.2020.05.008]
Surgical treatment of pulmonary metastases in pediatric solid tumors: a report of 80 cases
- Keywords:
- Lung Neoplasms; Neoplasm Metastasis; Thoracoscopy; Surgical Procedures; Operative; Therapy; Child
- CLC:
- R726.1;R734.2;R73-37
- Abstract:
- Objective To explore the surgical approaches and perioperative managements of pulmonary metastases in pediatric solid tumors.Methods Retrospective analysis was performed for the clinical data of 80 hospitalized children with pulmonary metastases of solid tumors from January 2012 to December 2018.Intraoperative findings,complications and outcomes were analyzed.Results A total of 114 resections of lung metastatic tumors were performed.The operative frequency was once (n=58),twice (n=13),thrice (n=6) and fourth (n=3).The median follow-up period was 30(0.4-76) months.Among 28 deaths,21(75%,21/28) were due to tumor recurrence and metastasis and 7(25%,7/28) non-tumor causes.The latter included 2 perioperative deaths.The rates of cumulative overall survival (OS) at 1/3/5 year were 88.8%,81.0% and 58.6% respectively by Kaplan-Meier method and cumulative event-free survival (EFS) at 1/3/5 year 88.8%,74.5% and 52.1% respectively.Conclusion Some children with pulmonary metastatsectomy in solid tumors may benefit from surgery.And the safety and complications of pulmonary metastases can be controlled.The principles of thorough exploration and complete resection should be followed.
References:
1 汤静燕.中国儿童恶性实体瘤诊断与治疗现状[J].中华儿科杂志,2017,55(10):721-723.DOI:10.3760/cma.j.issn.0578-1310.2017.10.001. Tang JY.Current status of diagnosis and treatment of pediatric malignant solid tumors in China[J].Chin J Pediatr,2017,55(10):721-723.DOI:10.3760/cma.j.issn.0578-1310.2017.10.001.
2 Fuchs J,Seitz G,Handgretinger R,et al.Surgical treatment of lung metastases in patients with embryonal pediatric solid tumors:an update[J].Semin Pediatr Surg,2012,21(1):79-87.DOI:10.1053/j.sempedsurg.2011.10.008.
3 Kayton ML.Pulmonary metastasectomy in pediatric patients[J].Thorac Surg Clin,2006,16(2):167-183.DOI:10.1016/j.thorsurg.2006.01.001.
4 董岿然.我国儿童胚胎性恶性实体肿瘤的研究和治疗进展[J].临床小儿外科杂志,2017,16(5):417-421.DOI:10.3969/j.issn.1671-6353.2017.05.001. Dong KR.Diagnosis and treatment of embryonic malignant tumors in children in China[J].J Clin Ped Sur,2017,16(5):417-421.DOI:10.3969/j.issn.1671-6353.2017.05.001.
5 Downey RJ.Surgical treatment of pulmonary metastases[J].Surg Oncol Clin N Am,1999,8(2):341.
6 Alexander J,Haight C.Pulmonary resection for solitary metastatic sarcomas and carcinomas[J].Surg Gynecol Obstet,1947,85(2):129-146.
7 Richardson WR.Progress in pediatric cancer surgery.Recent advances in the surgical management of neoplasms in infants and children[J].Arch Surg,1961,82:641-655.DOI:10.1001/archsurg.1961.01300110003001.
8 Thomford NR,Woolner LB,Clagett OT.The surgical treatment of metastatic tumors in the lungs[J].J Thorac Cardiovasc Surg,1965,49:357-363.
9 Pastorino U,Buyse M,Friedel G,et al.Long-term results of lung metastasectomy:prognostic analyses based on 5206 cases[J].J Thorac Cardiovasc Surg,1997,113(1):37-49.DOI:10.1016/s0022-5223(97)70397-0.
10 Erginel B,Gun Soysal F,Keskin E,et al.Pulmonary metastasectomy in pediatric patients[J].World J Surg Oncol,2016,14(1):27.DOI:10.1186/s12957-016-0788-6.
11 王成栋,吴晔明,吕凡,等.儿童恶性实体肿瘤的胸腔镜诊治及转归[J].中华小儿外科杂志,2018,39(1):31-34.DOI:10.3760/cma.j.issn.0253-3006.2018.01.007. Wang CD,Wu YM W,Lv F,et al.Applications and outcomes of thoracoscopy for pediatric malignant solid tumors[J].Chin J Pediatr Surg,2018,39(1):31-34.DOI:10.3760/cma.j.issn.0253-3006.2018.01.007.
12 张娜,屈彦超,曾骐.七例儿童早期肾母细胞瘤术后单纯肺转移的诊疗[J].中华小儿外科杂志,2018,39(1):53-56.DOI:10.3760/cma.j.issn.0253-3006.2018.01.012. Zhang N,Qu YC,Zeng Q.Postoperative treatment for pulmonary metastasis in children with Wilms’ tumor at stages I &Ⅱ:a report of 7 cases[J].Chin J Pediatr Surg,2018,(1):53-56.DOI:10.3760/cma.j.issn.0253-3006.2018.01.012.
13 Meng D,Fu L,Wang L,et al.Video-assisted thoracoscopic surgery versus open thoracotomy in pulmonary metastasectomy:a meta-analysis of observational studies[J].Interact Cardiovasc Thorac Surg,2016,22(2):200-206.DOI:10.1093/icvts/ivv309.
14 Cheang MY,Herle P,Pradhan N,et al.Video-assisted thoracoscopic surgery versus open thoracotomy for pulmonary metastasectomy:a systematic review[J].ANZ J Surg,2015,85(6):408-413.DOI:10.1111/ans.12925.
15 McCormack PM,Bains MS,Begg CB,et al.Role of video-assisted thoracic surgery in the treatment of pulmonary metastases:results of a prospective trial[J].Ann Thorac Surg,1996,62(1):213-217.DOI:10.1016/0003-4975(96)00253-6.
16 Sun F,Chen L,Shi M,et al.Prognosis of video-assisted thoracoscopic pulmonary metastasectomy in patients with colorectal cancer lung metastases:an analysis of 154 cases[J].Int J Colorectal Dis,2017,32(6):897-905.DOI:10.1007/s00384-017-2768-x.
17 王坤宇,王述民,曲家骐,等.经胸腔镜术治疗肺转移瘤患者23例临床分析[J].实用癌症杂志,2016,31(4):572-574.DOI:10.3969/j.issn.1001-5930.2016.04.016. Wang KY,Wang SM,Qu JQ,et al.Clinical analysis of thoracoscopy for 23 patients with pulmonary metastatic tumors[J].Practical Journal of Cancer,2016,31(4):572-574.DOI:10.3969/j.issn.1001-5930.2016.04.016.
18 Ellis MC,Hessman CJ,Weerasinghe R,et al.Comparison of pulmonary nodule detection rates between preoperative CT imaging and intraoperative lung palpation[J].Am J Surg,2011,201(5):619-622.DOI:10.1016/j.amjsurg.2011.01.005.
19 Cerfolio RJ,Bryant AS,McCarty TP,et al.A prospective study to determine the incidence of non-imaged malignant pulmonary nodules in patients who undergo metastasectomy by thoracotomy with lung palpation[J].Ann Thorac Surg,2011,91(6):1696-1700.DOI:10.1016/j.athoracsur.2011.02.075.
20 刘波,夏晖.肺转移瘤的外科治疗进展[J].中国肺癌杂志,2019,22(9):574-578.DOI:10.3779/j.issn.1009-3419.2019.09.04. Liu B,Xia H.Recent advances in surgery for pulmonary metastatic tumors[J].Chinese Journal of Lung Cancer,2019,22(9):574-578.DOI:10.3779/j.issn.1009-3419.2019.09.04.
21 Matsubara T,Toyokawa G,Kinoshita F,et al.Safety of simultaneous bilateral pulmonary resection for metastatic lung tumors[J].Anticancer Res,2018,38(3):1715-1719.DOI:10.21873/anticanres.12406.
22 Jeong S,Heo JS,Park JY,et al.Surgical resection of synchronous and metachronous lung and liver metastases of colorectal cancers[J].Ann Surg Treat Res,2017,92(2):82-89.DOI:10.4174/astr.2017.92.2.82.
23 Urla C,Seitz G,Tsiflikas I,et al.Simultaneous resection of high-risk liver tumors and pulmonary metastases in children[J].Ann Surg,2015,262(1):e1-e3.DOI:10.1097/SLA.0000000000001167.
24 Shi Y,Geller JI,Ma IT,et al.Relapsed hepatoblastoma confined to the lung is effectively treated with pulmonary metastasectomy[J].J Pediatr Surg,2016,51(4):525-529.DOI:10.1016/j.jpedsurg.2015.10.053.
Memo
收稿日期:2020-02-14。
基金项目:深圳医疗卫生三名工程(编号:SZSM201606088)
通讯作者:黄柳明,Email:surhlm@126.com