A modern approach to multiple pulmonary resections in children with recurrent metastatic pulmonary disease

Pediatr Blood Cancer. 2024 Nov;71(11):e31304. doi: 10.1002/pbc.31304. Epub 2024 Sep 3.

Abstract

Implications of repeated resections of pulmonary metastasis (PM) are not well documented in the modern era. Fifteen children underwent two (n = 8), three (n = 3), or four or more (n = 3) resections (total = 38 procedures), most commonly for osteosarcoma (71%). Operative approach included muscle-sparing thoracotomy (71%), non-muscle-sparing thoracotomy (18%), and video-assisted thoracoscopy (11%). Median resected nodules per procedure was four (range = 1-95). Prolonged air leaks were the most common postoperative complication (29%). Median hospital stay was 4 days, and no children were discharged with or have required oxygen. Event-free survival is 67% at median follow-up time of 54 months, with an overall survival rate of 64%. Repeat resection of PM appears to be well tolerated, without prolonged hospital stays or compromised pulmonary function.

Keywords: metastasis; pediatric surgical oncology; pulmonary resection; thoracoscopy; thoracotomy.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Neoplasms* / mortality
  • Lung Neoplasms* / pathology
  • Lung Neoplasms* / surgery
  • Male
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Osteosarcoma / mortality
  • Osteosarcoma / pathology
  • Osteosarcoma / surgery
  • Pneumonectomy / methods
  • Pneumonectomy / mortality
  • Retrospective Studies
  • Survival Rate
  • Thoracic Surgery, Video-Assisted / methods
  • Thoracotomy