The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Management of Pulmonary Metastasis

폐 전이 병변의 치료

  • Ryoo, Hun-Mo (Division of Hemato-oncology, Department of Internal Medicine, Catholic University of Daegu School of Medicine)
  • 류헌모 (대구가톨릭대학교 의과대학 내과학교실 혈액종양내과)
  • Published : 2011.09.01
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Abstract

The lung is a common site for metastasis of malignant tumors from other organs. The metastatic cascade is a complex process that involves a series of events. Tumors can spread to the lung through hematogenous or lymphangitic routes. In the absence of extrathoracic metastasis, complete resection is associated with increased survival, regardless of histology. With appropriate patient selection, life expectancy is often improved with pulmonary metastasectomy. Stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA) are 2 approaches that have been increasingly reported for pulmonary tumors. Although these new therapies have yet to match the long-term success rates of surgical therapy, the techniques demonstrate good results in treating high-risk surgical candidates with metastatic lesions to the lungs that would otherwise be considered with resection. This review will focus on the role of local therapy in oligometastasis that arise in the lung.

Keywords

References

  1. Krishnan K, Khanna C, Helman LJ. The molecular biology of pulmonary metastasis. Thorac Surg Clin 2006;16:115-124. https://doi.org/10.1016/j.thorsurg.2005.12.003
  2. The International Registry of Lung Metastases. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases: the International Registry of Lung Metastases. J Thorac Cardiovasc Surg 1997;113:37-49. https://doi.org/10.1016/S0022-5223(97)70397-0
  3. Yan TD, King J, Sjarif A, Glenn D, Steinke K, Morris DL. Percutaneous radiofrequency ablation of pulmonary metastases from colorectal carcinoma: prognostic determinants for survival. Ann Surg Oncol 2006;13:1529-1537. https://doi.org/10.1245/s10434-006-9101-1
  4. Coon D, Gokhale AS, Burton SA, Heron DE, Ozhasoglu C, Christie N. Fractionated stereotactic body radiation therapy in the treatment of primary, recurrent, and metastatic lung tumors: the role of positron emission tomography/computed tomography-based treatment planning. Clin Lung Cancer 2008;9:217-221. https://doi.org/10.3816/CLC.2008.n.032
  5. Okunieff P, Petersen AL, Philip A, et al. Stereotactic body radiation therapy (SBRT) for lung metastases. Acta Oncol 2006;45:808-817. https://doi.org/10.1080/02841860600908954
  6. von Herbay A, Illes A, Waldherr R, Otto HF. Pulmonary tumor thrombotic microangiopathy with pulmonary hypertension. Cancer 1990;66:587-592. https://doi.org/10.1002/1097-0142(19900801)66:3<587::AID-CNCR2820660330>3.0.CO;2-J
  7. Roberts KE, Hamele-Bena D, Saqi A, Stein CA, Cole RP. Pulmonary tumor embolism: a review of the literature. Am J Med 2003;115:228-232. https://doi.org/10.1016/S0002-9343(03)00305-X
  8. DeVita VT. Cancer: Principles & Practice of Oncology. 8th ed. Philadelphia: Lippincott Williams & Wilkins, 2008.
  9. Ichinose Y, Hara N, Ohta M, Kuda T, Asoh H, Chikama H. DNA ploidy patterns of tumors diagnosed as metachronous or recurrent lung cancers. Ann Thorac Surg 1991;52:469-473. https://doi.org/10.1016/0003-4975(91)90907-8
  10. Ichinose Y, Hara N, Ohta M. Synchronous lung cancers defined by deoxyribonucleic acid flow cytometry. J Thorac Cardiovasc Surg 1991;102:418-424.
  11. Snyder BJ, Pugatch RD. Imaging characteristics of metastatic disease to the chest. Chest Surg Clin N Am 1998;8:29-48.
  12. Gross BH, Glazer GM, Bookstein FL. Multiple pulmonary nodules detected by computed tomography: diagnostic implications. J Comput Assist Tomogr 1985;9:880-885. https://doi.org/10.1097/00004728-198509000-00007
  13. Remy-Jardin M, Remy J, Giraud F, Marquette CH. Pulmonary nodules: detection with thick-section spiral CT versus conventional CT. Radiology 1993;187:513-520.
  14. Whelan JS, Burcombe RJ, Janinis J, Baldelli AM, Cassoni AM. A systematic review of the role of pulmonary irradiation in the management of primary bone tumours. Ann Oncol 2002;13:23-30.
  15. Burgers JM, van Glabbeke M, Busson A, et al. Osteosarcoma of the limbs: report of the EORTC-SIOP 03 trial 20781 investigating the value of adjuvant treatment with chemotherapy and/or prophylactic lung irradiation. Cancer 1988;61:1024-1031. https://doi.org/10.1002/1097-0142(19880301)61:5<1024::AID-CNCR2820610528>3.0.CO;2-P
  16. Baeza MR, Barkley HT Jr, Fernandez CH. Total-lung irradiation in the treatment of pulmonary metastases. Radiology 1975;116:151-154.
  17. Baumann M, Appold S, Petersen C, Zips D, Herrmann T. Dose and fractionation concepts in the primary radiotherapy of non-small cell lung cancer. Lung Cancer 2001;33 Suppl l:S35-S45.
  18. Cesaretti JA, Pennathur A, Rosenstein BS, Swanson SJ, Fernando HC. Stereotactic radiosurgery for thoracic malignancies. Ann Thorac Surg 2008;85:S785-S791. https://doi.org/10.1016/j.athoracsur.2007.10.101
  19. Zheng Y, Fernando HC. Surgical and nonresectional therapies for pulmonary metastasis. Surg Clin North Am 2010;90:1041-1051. https://doi.org/10.1016/j.suc.2010.06.003
  20. Curley SA, Izzo F, Delrio P, et al. Radiofrequency ablation of unresectable primary and metastatic hepatic malignancies: results in 123 patients. Ann Surg 1999;230:1-8. https://doi.org/10.1097/00000658-199907000-00001
  21. Fernando HC. Radiofrequency ablation to treat non-small cell lung cancer and pulmonary metastases. Ann Thorac Surg 2008;85:S780-S784. https://doi.org/10.1016/j.athoracsur.2007.11.063
  22. Giovanella BC, Lohman WA, Heidelberger C. Effects of elevated temperatures and drugs on the viability of L1210 leukemia cells. Cancer Res 1970;30:1623-1631.
  23. Fishman AP. Fishman's Pulmonary Disease and Disorders. 4th ed. New York: McGraw-Hill, 2008.
  24. Mason RJ. Textbook of Respiratory Medicine. 5th ed. Philadelphia: Saunders Elsevier, 2010.
  25. Sellke FW. Surgery of the Chest. 8th ed. Philadelphia: Saunders Elsevier, 2010.
  26. Saeter G, Hoie J, Stenwig AE, Johansson AK, Hannisdal E, Solheim OP. Systemic relapse of patients with osteogenic sarcoma: prognostic factors for long term survival. Cancer 1995;75:1084-1093. https://doi.org/10.1002/1097-0142(19950301)75:5<1084::AID-CNCR2820750506>3.0.CO;2-F
  27. Meyers PA, Heller G, Healey JH, et al. Osteogenic sarcoma with clinically detectable metastasis at initial presentation. J Clin Oncol 1993;11:449-453.
  28. Billingsley KG, Burt ME, Jara E, et al. Pulmonary metastases from soft tissue sarcoma: analysis of patterns of diseases and postmetastasis survival. Ann Surg 1999;229:602-610; discussion 610-612. https://doi.org/10.1097/00000658-199905000-00002
  29. van Geel AN, Pastorino U, Jauch KW, et al. Surgical treatment of lung metastases: the European Organization for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group Study of 255 patients. Cancer 1996;77:675-682. https://doi.org/10.1002/(SICI)1097-0142(19960215)77:4<675::AID-CNCR13>3.0.CO;2-Y
  30. Pogrebniak HW, Roth JA, Steinberg SM, Rosenberg SA, Pass HI. Reoperative pulmonary resection in patients with metastatic soft tissue sarcoma. Ann Thorac Surg 1991;52:197-203. https://doi.org/10.1016/0003-4975(91)91336-T
  31. Casson AG, Putnam JB, Natarajan G, et al. Efficacy of pulmonary metastasectomy for recurrent soft tissue sarcoma. J Surg Oncol 1991;47:1-4. https://doi.org/10.1002/jso.2930470102
  32. Pihl E, Hughes ES, McDermott FT, Johnson WR, Katrivessis H. Lung recurrence after curative surgery for colorectal cancer. Dis Colon Rectum 1987;30:417-419. https://doi.org/10.1007/BF02556487
  33. Welter S, Jacobs J, Krbek T, Krebs B, Stamatis G. Long-term survival after repeated resection of pulmonary metastases from colorectal cancer. Ann Thorac Surg 2007;84:203-210. https://doi.org/10.1016/j.athoracsur.2007.03.028
  34. Friedel G, Pastorino U, Ginsberg RJ, et al. Results of lung metastasectomy from breast cancer: prognostic criteria on the basis of 467 cases of the International Registry of Lung Metastases. Eur J Cardiothorac Surg 2002;22:335-344. https://doi.org/10.1016/S1010-7940(02)00331-7
  35. Kavolius JP, Mastorakos DP, Pavlovich C, Russo P, Burt ME, Brady MS. Resection of metastatic renal cell carcinoma. J Clin Oncol 1998;16:2261-2266.36. Liu D, Abolhoda A, Burt ME, et al. Pulmonary metastasectomy for testicular germ cell tumors: a 28-year experience. Ann Thorac Surg 1998;66:1709-1714. https://doi.org/10.1016/S0003-4975(98)00940-0
  36. Liu D, Abolhoda A, Burt ME, et al. Pulmonary metastasectomy for testicular germ cell tumors: a 28-year experience. Ann Thorac Surg 1998;66:1709-1714. https://doi.org/10.1016/S0003-4975(98)00940-0
  37. Liu D, Labow DM, Dang N, et al. Pulmonary metastasectomy for head and neck cancers. Ann Surg Oncol 1999;6:572-578. https://doi.org/10.1007/s10434-999-0572-8
  38. Anderson TM, McMahon JJ, Nwogu CE, et al. Pulmonary resection in metastatic uterine and cervical malignancies. Gynecol Oncol 2001;83:472-476. https://doi.org/10.1006/gyno.2001.6427
  39. Mountain CF, McMurtrey MJ, Hermes KE. Surgery for pulmonary metastasis: a 20-year experience. Ann Thorac Surg 1984;38:323-330. https://doi.org/10.1016/S0003-4975(10)62280-1