Pulmonary metastasectomy

A survey of current practice amongst members of the european society of thoracic surgeons

Eveline Internullo, Stephen D. Cassivi, Dirk Van Raemdonck, Godehard Friedel, Tom Treasure

Research output: Contribution to journalArticle

153 Citations (Scopus)

Abstract

Objective: Currently, no randomized trials exist to guide thoracic surgeons in the field of pulmonary metastasectomy. This study investigates the current clinical practice among European Society of Thoracic Surgeon (ESTS) members. Methods: A Web-based questionnaire was created exploring the clinical approach to lung metastasectomy. All ESTS members were surveyed. Results: One hundred forty-six complete responses were received from the 494 consultant ESTS members surveyed (29.6%). For most respondents (68%), lung metastasectomy represents a minor proportion (0-10%) of their clinical volume. Approximately 90% of respondents always/usually review their lung metastasectomy cases within a multidisciplinary meeting. Helical computed tomography is most commonly used (74%) for the detection of metastases, while positron emission tomography is used additionally in less than 50%. Most of respondents (92% and 74%, respectively) consider unresectable primary tumor and predicted incomplete metastasectomy as absolute contraindications to lung metastasectomy. The most frequently performed resection is wedge excision (92%). Palpation of the lung is considered necessary by 65%, while 40% use a thoracoscopic approach with therapeutic intent. Though 65% consider pathologically positive nodes a contraindication to metastasectomy, a similar number rarely/never perform mediastinoscopy before metastasectomy. At the time of metastasectomy 55% perform mediastinal lymph node sampling whereas 33% perform no nodal dissection whatsoever. Conclusions: The survey provides a large, time-sensitive database summarizing the clinical practice of pulmonary metastasectomy by members of the ESTS. Responses demonstrate a remarkable consistency of practice patterns, though certain areas of potential controversy showed greater variance. Conceivably, these divergent approaches will encourage future collaborative studies aimed at identifying evidence-based practices for patients with pulmonary metastases.

Original languageEnglish (US)
Pages (from-to)1257-1266
Number of pages10
JournalJournal of Thoracic Oncology
Volume3
Issue number11
DOIs
StatePublished - Nov 2008

Fingerprint

Metastasectomy
Thorax
Lung
Surgeons
Surveys and Questionnaires
Neoplasm Metastasis
Mediastinoscopy
Spiral Computed Tomography
Palpation
Evidence-Based Practice
Consultants
Positron-Emission Tomography
Dissection
Lymph Nodes

Keywords

  • Lung metastases
  • Metastasectomy
  • Survey

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Medicine(all)

Cite this

Pulmonary metastasectomy : A survey of current practice amongst members of the european society of thoracic surgeons. / Internullo, Eveline; Cassivi, Stephen D.; Van Raemdonck, Dirk; Friedel, Godehard; Treasure, Tom.

In: Journal of Thoracic Oncology, Vol. 3, No. 11, 11.2008, p. 1257-1266.

Research output: Contribution to journalArticle

Internullo, Eveline ; Cassivi, Stephen D. ; Van Raemdonck, Dirk ; Friedel, Godehard ; Treasure, Tom. / Pulmonary metastasectomy : A survey of current practice amongst members of the european society of thoracic surgeons. In: Journal of Thoracic Oncology. 2008 ; Vol. 3, No. 11. pp. 1257-1266.
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