Pulmonary Metastasectomy A Survey of Current Practice Amongst Members of the European Society of Thoracic Surgeons
(2008) Journal of Thoracic Oncology — Vol. 3, n° 11, p. 1257-1266 (2008)
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- 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.
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Internullo, E., Cassivi, S. D., Van Raemdonck, D., Friedel, G., & Treasure, T. (2008). Pulmonary Metastasectomy A Survey of Current Practice Amongst Members of the European Society of Thoracic Surgeons. Journal of Thoracic Oncology, 3(11), 1257-1266. https://doi.org/10.1097/JTO.0b013e31818bd9da (Original work published 2008)