Die Resektion solitärer Lungenmetastasen des Urothelkarzinom kann das Überleben bei selektionierten Patienten verlängern

Zusammenfassung

Die aktuelle Datenlage der pulmonalen Metastasektomie des Urothelkarzinoms ist stark begrenzt. In unserer aktuellen Studie haben wir basierend auf unserer 20-jährigen Zentrumserfahrung das Langzeitergebnis nach Lungenmetastasektomie bei Urothelkarzinom sowie die Faktoren, die ein Langzeitüberleben beeinflussen, untersucht. Bei insgesamt 18 Patienten (4 Frauen und 14 Männer) wurde eine Lungenmetastasektomie bei Urothelkarzinom in den Jahren von 2000 bis 2020 in kurativer Intention durchgeführt. Klinische, demografische und chirurgische Daten wurden retrospektiv analysiert. Das krankheitsfreie Intervall zwischen Behandlung des Primarius und Lungenmetastasektomie umfasste 1 bis 48 Monate. Die Überlebensanalyse wurde nach der Kaplan-Meier-Methode und dem Log-Rank-Test durchgeführt. Das kumulative 3- und 5-Jahres-Überleben betrug 84,7% und 52,9%. Die Resektion einer solitären Lungenmetastase war ein unabhängiger positiver Prädiktor für ein längerfristiges Überleben (p = 0,04). Die pulmonale Metastasektomie bei Urothelkarzinom ist mit einem günstigeren Langzeitergebnis verbunden und singuläre Metastasen mit einem verlängerten Langzeitüberleben. Die operative Resektion solitärer Lungenmetastasen und die Metastasektomie bei Rezidivmetastase des Urothelkarzinoms ist eine praktikable Therapie bei selektierten Patienten.

Abstract

There are only a few small published studies on pulmonary metastasectomy for urinary tract transitional cell carcinoma (TCC). In this study, we examined the long-term outcome and the prognostic survival factors associated with pulmonary metastasectomy of urinary tract TCC, as based on our centre’s 20-year experience. Between 2000 and 2020, curative pulmonary metastasectomy was performed in 18 patients (14 males and 4 females). Clinical, demographical and surgical data were retrospectively analysed. The disease-free interval between treatment of the primary tumour and pulmonary metastasectomy ranged from one to 48 months. Survival analysis was conducted with the Kaplan-Meier method and log-rank test. The 3- and 5-year survival rates were 84.7% and 52.9%, respectively. Resection of solitary metastases was a positive and independent factor for survival (p = 0.04). Pulmonary metastasectomy of urinary tract TCC is associated with a favourable outcome and solitary metastasis is associated with long-term survival. Surgical resection of solitary pulmonary metastasis and repeated lung metastasectomy by pulmonary recurrence from a urinary tract TCC is feasible in selected patients.

Schlüsselwörter

Metastase - Urothelkarzinom - Blasenkarzinom - Lungenmetastasektomie

Keywords

bladder cancer - metastases - urothelial carcinoma - pulmonary metastasectomy

Publication History

Received: 05 May 2022

Accepted after revision: 31 July 2023

Article published online:
05 September 2023

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