Abstract
Objective We wanted to assess the prognostic factors and the efficacy of the treatment in patients
who underwent lung resections for transitional cell carcinoma metastases.
Materials and Methods This is a retrospective, multicenter study. Between January 1995 and May 2014, 69
patients underwent lung metastasectomy with curative intent. We evaluated primary
site of the tumor, the role of adjuvant chemotherapy after urological operation, disease-free
interval (DFI; lower or higher than 24 months), type of lung resection, number of
lung metastases, presence of metastatic lymph nodes, and diameter of the metastasis
(less or more than 3 cm).
Results Among 69 patients, 55 (79%) had bladder as primary site of disease and 12 of them
received a transurethral bladder resection. Fourteen (21%) patients developed primary
tumor in the renal pelvis or ureter; 53 (76%) patients presented with a single metastasis,
16 (24%) with multiple metastasis. The median DFI was 37 months and the median follow-up
was 50 months. Sampling lymphadenectomy was done in 42 patients and nodal metastases
were found in 7 patients. The overall 5-year survival was 52%, median 62 months. At
univariate analysis, the DFI had a significant impact on survival (5-year survival
of 58% for patients with DFI ≥ 24 months vs. 46%; p = 0.048) and diameter of metastasis (5-year survival of 59% for diameter less than
3 cm group vs. 33%; p = 0.001). The multivariate analysis confirmed metastasis' diameter as an independent
prognostic factor (p = 0.001).
Conclusion Our study found that, in addition to DFI that remains a common prognostic factor
in patients with metastatic lung disease, in lung metastases by transitional cell
carcinoma, the diameter of the lesion is another significant prognostic factor.
Keywords
metastases/metastasectomy - lung cancer treatment - surgery, medical
