Survival outcomes of resection for pulmonary malignancies including non-small cell lung cancer and pulmonary metastasis
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ORIGINAL ARTICLE
Survival outcomes of resection for pulmonary malignancies including non‑small cell lung cancer and pulmonary metastasis after esophagectomy for esophageal carcinoma Keiji Yamanashi1 · Masatsugu Hamaji1 · Shigeru Tsunoda2 · Takao Nakanishi3 · Mitsugu Omasa3 · Naoki Nakajima4 · Akihiro Ohsumi1 · Toshi Menju1 · Toyofumi Fengshi Chen‑Yoshikawa5 · Hiroshi Date1 Received: 11 January 2020 / Accepted: 15 April 2020 © The Japanese Association for Thoracic Surgery 2020
Abstract Objectives This study investigated survival outcomes of resection for pulmonary malignancies after esophagectomy for esophageal carcinoma, comparing non-small cell lung cancer and pulmonary metastases. Methods We retrospectively reviewed consecutive patients who underwent resection for pulmonary malignancies after esophagectomy for esophageal carcinoma between 2009 and 2018. The overall survival and relapse-free survival rate were assessed using Kaplan–Meier analysis. Results Eleven patients had non-small cell lung cancer and eight patients had pulmonary metastases from esophageal carcinoma. The 5-year overall survival rate was 92.9% in all patients with a median follow-up period of 50.4 (range: 9.1–130.2) months. While the 5-year overall survival rate was 100.0% in patients with non-small cell lung cancer, it was 85.7% in patients with pulmonary metastases from esophageal carcinoma. The 5-year relapse-free survival rate was 85.7% in patients with non-small cell lung cancer. Conclusions Our data suggest that resection for pulmonary malignancies after esophagectomy for esophageal carcinoma is associated with favorable survival outcomes and should be considered in selected patients. Keywords Esophagectomy · Esophageal carcinoma · Non-small cell lung cancer
Introduction Multimodal treatment combining surgical resection, radiation and chemotherapy improved the prognosis of patients with esophageal carcinoma [1, 2]. The lung is one of the * Masatsugu Hamaji [email protected]‑u.ac.jp 1
Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin‑Kawahara‑cho, Sakyo‑ku, Kyoto 606‑8507, Japan
2
Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
3
Department of Thoracic Surgery, Kobe City Nishi-Kobe Medical Center, Kobe, Japan
4
Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
5
Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
most common sites of metastasis from esophageal carcinoma after multimodal treatment [3, 4]. However, it is difficult to clinically or histologically distinguish between pulmonary metastases from esophageal carcinoma and primary lung cancer (non-small cell lung cancer, NSCLC), especially in squamous cell carcinoma, since they cannot be completely differentiated for their histopathological features or radiographic appearance [5]. Therefore, the accurate diagnosis of pulmonary nodule after esophagectomy for esophageal carcinoma is usually obtained after pulmonary re
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