Role of video-assisted thoracic surgery in the treatment of pulmonary metastases: Results of a prospective trial Journal Article


Authors: McCormack, P. M.; Bains, M. S.; Begg, C. B.; Burt, M. E.; Downey, R. J.; Panicek, D. M.; Rusch, V. W.; Zakowski, M.; Ginsberg, R. J.
Article Title: Role of video-assisted thoracic surgery in the treatment of pulmonary metastases: Results of a prospective trial
Abstract: Background. A retrospective review revealed a 42% error rate between computed tomographic scan reports and thoracotomy findings; therefore, a prospective study was designed to compare the value of computed tomographic scans, video-assisted thoracoscopic exploration, and open thoracotomy in the management of pulmonary metastases. Methods. Eligibility included any patient with only one or two ipsilateral pulmonary metastases identified on computed tomographic scan who was being considered for surgical resection. Initially video-assisted thoracic surgery was performed and all lesions identified were resected. A thoracotomy adequate for complete lung palpation was then carried out and any additional lesions found were removed. Results. Eighteen patients of a planned 50 were treated before closure of the study. Four patients (22%) had no additional lesions found at thoracotomy. The primary sites of tumor were colon (10), breast (3), and one patient each skin (squamous), cervix, kidney, melanoma, and sarcoma. Four patients (22%) did have additional lesions at thoracotomy, which were benign. In the remaining 10 patients (56%) additional malignant lesions were found at thoracotomy after video-assisted thoracoscopic exploration. After 18 patients were entered, analysis of the early results disclosed a 56% failure rate of a computed tomographic scan and video-assisted thoracic surgery to detect all lesions. Being within the 95% confidence interval (32% to 78%), the study was abandoned. Conclusions. We conclude that video-assisted thoracic surgery should be used only as a diagnostic tool in managing lung metastasis. A thoracotomy is required to achieve complete resection, which is the major survival prognosticator for satisfactory long-term results.
Keywords: clinical article; controlled study; methodology; thoracotomy; skin cancer; lung metastasis; pneumothorax; colon cancer; thorax surgery; human; priority journal; article
Journal Title: Annals of Thoracic Surgery
Volume: 62
Issue: 1
ISSN: 0003-4975
Publisher: Elsevier Science, Inc.  
Date Published: 1996-07-01
Start Page: 213
End Page: 216; discussion 216-217
Language: English
DOI: 10.1016/0003-4975(96)00253-6
PUBMED: 8678645
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 22 November 2017 -- Source: Scopus
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MSK Authors
  1. Colin B Begg
    306 Begg
  2. David M Panicek
    135 Panicek
  3. Valerie W Rusch
    865 Rusch
  4. Robert J Ginsberg
    178 Ginsberg
  5. Maureen F Zakowski
    289 Zakowski
  6. Robert J Downey
    254 Downey
  7. Manjit S Bains
    338 Bains
  8. Michael E. Burt
    187 Burt