Analysis of sternotomy as treatment option for the resection of bilateral pulmonary metastases in pediatric solid tumors
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Analysis of sternotomy as treatment option for the resection of bilateral pulmonary metastases in pediatric solid tumors. / Fuchs, Jörg; Seitz, Guido; Ellerkamp, Verena; Dietz, Klaus; Bosk, Axel; Müller, Ingo; Warmann, Steven W; Schäfer, Jürgen F.
in: J SURG ONCOL, Jahrgang 17, Nr. 4, 12.2008, S. 323-30.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Analysis of sternotomy as treatment option for the resection of bilateral pulmonary metastases in pediatric solid tumors
AU - Fuchs, Jörg
AU - Seitz, Guido
AU - Ellerkamp, Verena
AU - Dietz, Klaus
AU - Bosk, Axel
AU - Müller, Ingo
AU - Warmann, Steven W
AU - Schäfer, Jürgen F
PY - 2008/12
Y1 - 2008/12
N2 - BACKGROUND: Radical surgical resection of metastases is an important prognostic factor for survival of patients suffering from solid pediatric tumors. The aim of this study is to evaluate the efficacy of median sternotomy as treatment option for the resection of multiple bilateral lung metastases in children with different tumor entities. Furthermore, the sensitivity of preoperative imaging (CT) was assessed by intraoperative findings.PATIENTS AND METHODS: Between 2002 and 2007, 13 children (4 with sarcoma, 4 with nephroblastoma, 5 with hepatoblastoma) underwent median sternotomy for resection of bilateral lung metastases after R0-resection of the primary tumor. In 6/13 cases, the sternotomy was combined with the primary tumor resection.RESULTS: Median patient age at the first operation was 5 years (range: 11 months to 17 years). The median total number of resected metastases per operation was 9 and ranged from 0 to 65. In 13/16 operations, the intraoperative number of metastases did not agree with the preoperative radiological work-up. Median hospital stay was 14 days (range from 9 to 36 days). Ten out of 13 children are alive after a median follow-up of 13 months (range from 6 to 66 months).CONCLUSION: Median sternotomy is an adequate treatment modality for the resection of bilateral pulmonary metastases as a one-stage procedure. The combination of primary tumor resection with sternotomy should be considered as a treatment option. Complete resection of metastases of solid pediatric tumors should be aimed for in order to increase the survival of these patients.
AB - BACKGROUND: Radical surgical resection of metastases is an important prognostic factor for survival of patients suffering from solid pediatric tumors. The aim of this study is to evaluate the efficacy of median sternotomy as treatment option for the resection of multiple bilateral lung metastases in children with different tumor entities. Furthermore, the sensitivity of preoperative imaging (CT) was assessed by intraoperative findings.PATIENTS AND METHODS: Between 2002 and 2007, 13 children (4 with sarcoma, 4 with nephroblastoma, 5 with hepatoblastoma) underwent median sternotomy for resection of bilateral lung metastases after R0-resection of the primary tumor. In 6/13 cases, the sternotomy was combined with the primary tumor resection.RESULTS: Median patient age at the first operation was 5 years (range: 11 months to 17 years). The median total number of resected metastases per operation was 9 and ranged from 0 to 65. In 13/16 operations, the intraoperative number of metastases did not agree with the preoperative radiological work-up. Median hospital stay was 14 days (range from 9 to 36 days). Ten out of 13 children are alive after a median follow-up of 13 months (range from 6 to 66 months).CONCLUSION: Median sternotomy is an adequate treatment modality for the resection of bilateral pulmonary metastases as a one-stage procedure. The combination of primary tumor resection with sternotomy should be considered as a treatment option. Complete resection of metastases of solid pediatric tumors should be aimed for in order to increase the survival of these patients.
KW - Adolescent
KW - Bone Neoplasms
KW - Child
KW - Child, Preschool
KW - Female
KW - Fibrosarcoma
KW - Follow-Up Studies
KW - Germany
KW - Hepatoblastoma
KW - Humans
KW - Infant
KW - Kidney Neoplasms
KW - Liver Neoplasms
KW - Lung Neoplasms
KW - Male
KW - Osteosarcoma
KW - Pneumonectomy
KW - Retrospective Studies
KW - Sternum
KW - Survival Rate
KW - Treatment Outcome
KW - Wilms Tumor
U2 - 10.1016/j.suronc.2008.05.004
DO - 10.1016/j.suronc.2008.05.004
M3 - SCORING: Journal article
C2 - 18586485
VL - 17
SP - 323
EP - 330
JO - J SURG ONCOL
JF - J SURG ONCOL
SN - 0022-4790
IS - 4
ER -