BOOK
Pulmonary Metastasectomy, An Issue of Thoracic Surgery Clinics of North America, E-Book
Mark W. Onaitis | Thomas A. D’Amico
(2016)
Additional Information
Book Details
Abstract
This issue of Thoracic Surgery Clinics of North America focuses on Pulmonary Metastasectomy. Articles will include: Biology of Pulmonary Metastases; Preoperative Evaluations and Indications for Metastasectomy; Open Approaches to Pulmonary Metastases: Thoracotomy and Sternotomy; Ablative Approaches for Pulmonary Metastases: RFA, microwave, SBRT; Role of Lymphadenectomy with Pulmonary Metastasectomy; Results of Pulmonary Resection: Colorectal Carcinoma; Results of Pulmonary Resection: Sarcoma and Germ Cell Tumors; Isolated Lung Perfusion; Immunotherapy; Medical Management of Pulmonary Metastases: Is There a Role for Surgery?; Thoracoscopic Management of Pulmonary Metastases; Results of Pulmonary Resection: Other Epithelial Malignancies; Thoracoscopic Lung Suffusion; and more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Pulmonary Metastasectomy\r | i | ||
| Copyright \r | ii | ||
| Contributors | iii | ||
| CONSULTING EDITOR | iii | ||
| EDITORS | iii | ||
| AUTHORS | iii | ||
| Contents | v | ||
| Preface: Modern Management of Pulmonary Metastases\r | v | ||
| The Biology of Pulmonary Metastasis\r | v | ||
| Preoperative Evaluation and Indications for Pulmonary Metastasectomy\r | v | ||
| Open Surgical Approaches for Pulmonary Metastasectomy\r | v | ||
| Ablative Approaches for Pulmonary Metastases\r | v | ||
| Lymphadenectomy During Pulmonary Metastasectomy\r | vi | ||
| Results of Pulmonary Resection: Colorectal Carcinoma\r | vi | ||
| Results of Pulmonary Resection: Sarcoma and Germ Cell Tumors\r | vi | ||
| Isolated Lung Perfusion for Pulmonary Metastases\r | vi | ||
| Immunotherapy for Resected Pulmonary Metastases\r | vii | ||
| Is Surgery Warranted for Oligometastatic Disease?\r | vii | ||
| Thoracoscopic Management of Pulmonary Metastases\r | vii | ||
| Results of Pulmonary Resection: Other Epithelial Malignancies\r | vii | ||
| Thoracoscopic Lung Suffusion\r | viii | ||
| THORACIC SURGERY CLINICS\r | ix | ||
| FORTHCOMING ISSUES | ix | ||
| May 2016 | ix | ||
| August 2016 | ix | ||
| November 2016 | ix | ||
| RECENT ISSUES | ix | ||
| November 2015 | ix | ||
| August 2015 | ix | ||
| May 2015 | ix | ||
| Preface: Modern Management of Pulmonary Metastases\r | xi | ||
| The Biology of Pulmonary Metastasis | 1 | ||
| Key points | 1 | ||
| INTRODUCTION | 1 | ||
| AN OVERVIEW OF THE PATHOGENESIS OF METASTASIS | 1 | ||
| The Heterogeneity of Metastasis | 2 | ||
| The Clonality of Metastasis | 2 | ||
| SEED AND SOIL, REVISITED | 2 | ||
| THE BIOLOGY OF SUCCESSFUL METASTATIC CELLS (“SEED”) | 2 | ||
| Loss of Adherence and Epithelial to Mesenchymal Transition | 3 | ||
| Cell Motility | 3 | ||
| Survival and Arrest in Transit | 3 | ||
| Extravasation | 4 | ||
| THE BIOLOGY OF THE ORGAN MICROENVIRONMENT (“SOIL”) | 4 | ||
| SUMMARY | 4 | ||
| REFERENCES | 4 | ||
| Preoperative Evaluation and Indications for Pulmonary Metastasectomy | 7 | ||
| Key points | 7 | ||
| PREOPERATIVE EVALUATION | 7 | ||
| History and Physical Examination | 7 | ||
| Imaging | 8 | ||
| Mediastinal Staging | 8 | ||
| Pulmonary Function Testing | 8 | ||
| Evaluation of Extrathoracic Metastasis | 9 | ||
| Summary | 9 | ||
| INDICATIONS FOR METASTASECTOMY | 9 | ||
| Primary Malignancy Must be Controlled or Controllable | 9 | ||
| Extrathoracic Metastasis Must be Controlled or Controllable | 10 | ||
| All of the Tumor Must be Completely Resectable with Adequate Remaining Pulmonary Reserve | 10 | ||
| No Superior Alternative Nonoperative Management | 10 | ||
| SUMMARY | 10 | ||
| REFERENCES | 11 | ||
| Open Surgical Approaches for Pulmonary Metastasectomy | 13 | ||
| Key points | 13 | ||
| BACKGROUND | 13 | ||
| INTRODUCTION OF VIDEO-ASSISTED THORACIC SURGERY TECHNIQUES | 14 | ||
| POSTEROLATERAL THORACOTOMY | 15 | ||
| MUSCLE-SPARING INCISIONS | 16 | ||
| MEDIAN STERNOTOMY | 16 | ||
| EXTENDED INCISIONS | 16 | ||
| Clamshell Thoracotomy | 16 | ||
| Hemiclamshell Thoracotomy | 17 | ||
| REFERENCES | 18 | ||
| Ablative Approaches for Pulmonary Metastases | 19 | ||
| Key points | 19 | ||
| INTRODUCTION | 19 | ||
| BACKGROUND | 20 | ||
| Role of Ablative Therapies | 20 | ||
| General Principles of Ablative Therapies | 20 | ||
| ABLATIVE RADIOTHERAPY FOR PULMONARY METASTASES | 21 | ||
| Background | 21 | ||
| Technical Aspects | 22 | ||
| Clinical Results | 24 | ||
| Toxicity | 27 | ||
| Combining Ablative Radiotherapy and Systemic Therapy | 28 | ||
| Ongoing Studies | 28 | ||
| RADIOFREQUENCY ABLATION | 29 | ||
| Technique | 29 | ||
| Outcomes | 29 | ||
| MICROWAVE ABLATION | 31 | ||
| SUMMARY | 31 | ||
| REFERENCES | 31 | ||
| Lymphadenectomy During Pulmonary Metastasectomy | 35 | ||
| Key points | 35 | ||
| INTRODUCTION | 35 | ||
| INCIDENCE | 35 | ||
| LYMPH NODE SAMPLING VERSUS LYMPHADENECTOMY | 36 | ||
| PROGNOSIS | 38 | ||
| THERAPEUTIC IMPLICATIONS | 39 | ||
| SUMMARY | 39 | ||
| REFERENCES | 40 | ||
| Results of Pulmonary Resection | 41 | ||
| Key points | 41 | ||
| INTRODUCTION | 41 | ||
| PATIENT SELECTION AND OPERATIVE TECHNIQUE | 42 | ||
| NONOPERATIVE AND HYBRID TREATMENT OF PULMONARY METASTASES | 42 | ||
| PROGNOSTIC FACTORS FOR COLORECTAL PULMONARY METASTASECTOMY | 43 | ||
| SIZE AND LOCATION OF METASTASIS | 44 | ||
| NUMBER OF METASTASES | 44 | ||
| LYMPH NODE METASTASES | 44 | ||
| PREOPERATIVE CARCINOEMBRYONIC ANTIGEN LEVEL | 44 | ||
| DISEASE-FREE INTERVAL | 44 | ||
| NEW PROGNOSTIC INDICATORS | 45 | ||
| THE FUTURE | 45 | ||
| REFERENCES | 45 | ||
| Results of Pulmonary Resection | 49 | ||
| Key points | 49 | ||
| INTRODUCTION: NATURE OF THE PROBLEM | 49 | ||
| THERAPEUTIC OPTIONS AND SURGICAL TECHNIQUE | 49 | ||
| CLINICAL OUTCOMES | 50 | ||
| Sarcoma | 50 | ||
| Germ Cell Tumors | 51 | ||
| COMPLICATIONS AND CONCERNS | 52 | ||
| SUMMARY | 52 | ||
| REFERENCES | 53 | ||
| Isolated Lung Perfusion for Pulmonary Metastases | 55 | ||
| Key points | 55 | ||
| INTRODUCTION | 55 | ||
| SURGICAL TECHNIQUE | 56 | ||
| Variations of the Isolated Lung Perfusion Technique | 57 | ||
| Antegrade versus retrograde perfusion | 57 | ||
| Blood flow occlusion technique | 57 | ||
| Endovascular Blood Flow Occlusion Technique | 57 | ||
| Delayed Clamp Release | 57 | ||
| Selective Pulmonary Artery Perfusion | 57 | ||
| Hyperthermia | 57 | ||
| Video-Assisted Transcatheter Isolated Lung Perfusion | 58 | ||
| CLINICAL OUTCOMES | 58 | ||
| Doxorubicin | 58 | ||
| 5-Flurodeoxyuridine | 58 | ||
| Tumor Necrosis Factor Alpha | 62 | ||
| Paclitaxel | 62 | ||
| Melphalan | 62 | ||
| Gemcitabine | 62 | ||
| Cisplatin | 63 | ||
| COMPLICATIONS AND CONCERNS | 64 | ||
| Direct Lung Injury | 64 | ||
| Systemic Toxicity | 64 | ||
| Lung to Tumor Drug Concentration | 65 | ||
| Heterogeneous Drug Distribution | 65 | ||
| SUMMARY | 65 | ||
| REFERENCES | 65 | ||
| Immunotherapy for Resected Pulmonary Metastases | 69 | ||
| Key points | 69 | ||
| BACKGROUND ON IMMUNE SYSTEM AND IMMUNOTHERAPY/IMMUNITY IN THE LUNG | 69 | ||
| MELANOMA | 70 | ||
| RENAL CELL CARCINOMA | 72 | ||
| SARCOMA | 73 | ||
| COLON CANCER | 74 | ||
| OTHER MALIGNANCIES | 75 | ||
| SUMMARY | 75 | ||
| REFERENCES | 75 | ||
| Is Surgery Warranted for Oligometastatic Disease? | 79 | ||
| Key points | 79 | ||
| THE PARADIGM OF CANCER SURGERY WITH INTENT TO CURE | 79 | ||
| DEFINING TERMS: OLIGOMETASTASIS | 80 | ||
| DEFINING TERMS: WARRANTED | 82 | ||
| DEFINING TERMS: EFFICACY AND EFFECTIVENESS | 82 | ||
| PALLIATIVE SURGERY | 82 | ||
| SURGERY INTENDED TO CURE | 82 | ||
| SURGERY TO IMPROVE SURVIVAL | 83 | ||
| A QUESTION OF ATTRIBUTION: EFFECT OF SURGERY OR OF SELECTION FOR SURGERY? | 83 | ||
| COLORECTAL CANCER AND THE DRIVE TOWARD METASTASECTOMY | 84 | ||
| LUNG METASTASECTOMY FOR COLORECTAL CANCER: THE STATE OF THE EVIDENCE | 86 | ||
| LUNG METASTASECTOMY FOR SARCOMA: THE STATE OF THE EVIDENCE | 87 | ||
| WHERE IS LUNG METASTASECTOMY HEADING? | 87 | ||
| WHY IS THERE IS ENTHUSIASM FOR METASTASECTOMY? | 88 | ||
| REFERENCES | 88 | ||
| Thoracoscopic Management of Pulmonary Metastases | 91 | ||
| Key points | 91 | ||
| INTRODUCTION | 91 | ||
| THORACOSCOPIC PULMONARY METASTASECTOMY | 92 | ||
| SURGICAL TECHNIQUE | 92 | ||
| Preoperative Planning | 92 | ||
| Preparation and Patient Positioning | 93 | ||
| Surgical Approach | 93 | ||
| Surgical Procedure | 93 | ||
| REHABILITATION AND RECOVERY | 94 | ||
| CLINICAL RESULTS IN THE LITERATURE | 95 | ||
| SUMMARY | 96 | ||
| REFERENCES | 96 | ||
| Results of Pulmonary Resection | 99 | ||
| Key points | 99 | ||
| THE ROLE OF METASTASECTOMY IN PATIENTS WITH BREAST CANCER | 99 | ||
| DIAGNOSIS | 100 | ||
| LUNG CANCER VERSUS METASTASIS BREAST CANCER | 100 | ||
| SURVIVAL | 100 | ||
| PROGNOSTIC FACTORS | 101 | ||
| PROGNOSTIC GROUPS | 102 | ||
| THE ROLE OF METASTASECTOMY IN PATIENTS WITH RENAL CELL CANCER | 102 | ||
| DIAGNOSIS | 103 | ||
| SURVIVAL | 103 | ||
| PROGNOSTIC FACTORS OF SURVIVAL | 104 | ||
| PROGNOSTIC GROUPS | 105 | ||
| LYMPH NODE DISSECTION AT LUNG METASTASECTOMY FOR RENAL CELL CANCER | 105 | ||
| REFERENCES | 106 | ||
| Thoracoscopic Lung Suffusion | 109 | ||
| Key points | 109 | ||
| INTRODUCTION | 109 | ||
| Burden of Pulmonary Metastatic Disease | 109 | ||
| Brief Overview of Suffusion | 109 | ||
| Synopsis of Competing Open or Minimally Invasive Options | 110 | ||
| Anatomy and Physiology Behind Suffusion | 110 | ||
| PRECLINICAL WORK SUPPORTING SUFFUSION | 110 | ||
| Surgical Access and Control of Pulmonary Vasculature | 110 | ||
| Index | 123 |