Surgical Outcomes Following Pulmonary Metastasectomy in Iceland

Introduction: Pulmonary metastases usually indicate an advanced systemic disease and are generally associated with a poor prognosis. A small, carefully selected proportion of patients with pulmonary metastases undergo surgery. Aim: To evaluate the outcomes and trends of pulmonary metastasectomies performed in Iceland. Methods: This retrospective cohort study included all patients who underwent pulmonary metastasectomy in Iceland from 2001 to 2021. Clinical data were obtained from medical records. The study period was divided into three seven-year intervals for comparison. Survival was analyzed using Kaplan-Meier curves, and prognostic factors were assessed using Cox regression. The average follow-up time was 5.7 years, with survival calculated from the date of the first pulmonary metastasectomy. Results: A total of 179 pulmonary metastasectomies were performed, including 140 (78.2%) first-time procedures and 39 (21.8%) repeat surgeries. Almost half of the pulmonary metastasectomies (46.4%) occurred in the last period (2015–2021), while 26.8% were in the first period (2001–2007). Median age for patients undergoing their first surgery was 62 years. The most common indication was metastatic colorectal cancer (39.2%), followed by renal cell carcinoma (16,4%) and sarcoma (9,7%). Early major postoperative complications occurred in 3.4% of cases, with a 30-day mortality rate of 1.1%. Five-year survival improved significantly from 31.4% in 2001–2007 to 55.3% in 2015–2021 (p=0.031). Negative prognostic factors included advanced age, earlier treatment period, higher number of metastases, and sarcoma metastases. Discussion: Pulmonary metastasectomy has become more frequent in Iceland, with improved long-term outcomes, probably related to better patient selection and improved adjuvant chemotherapy. The procedure is associated with a low complication rate and 5-year survival outcomes comparable to international data.

Author dc:creator

• Carlos Magnús Rabelo 2001-

Contributors dc:contributor

• Háskóli Íslands

• Læknisfræði
• Lungu
• Meinvörp
• Skurðlækningar
• Krabbamein

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/1946/50471

OAI identifier oai:identifier

oai:skemman.is:1946/50471