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The Journal of Cardiovascular Surgery 2001 Dicembre;42(6):829-33

lingua: Inglese

Combined resection and adjuvant therapy improves prognosis of sarcomas of the pulmonary trunk

Genoni M., Biraima A. M., Bode B. *, Shan A. C., Wilkler M. B., Turina M. I.

From the Cardiovascular Surgery Clinic Triemli Hospital and University Hospital, Zurich, Switzerland
*Institute of Clinical Pathology University Hospital, Zurich, Switzerland


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Background. Diagnosis of pul­mo­nary ­artery sar­co­ma is dif­fi­cult and fre­quent­ly ­delayed ­owing to the insid­i­ous, non-spe­cif­ic ­nature of the symp­toms. We ­present our expe­ri­ence ­with sur­gery for ­this ­rare dis­ease.
Methods. Between 1995 and 1998, ­four ­patients under­went sur­gery for pul­mo­nary ­trunk sar­co­mas. They pre­sent­ed ­with sim­i­lar symp­toms and ­were initial­ly treat­ed for throm­boem­bol­ic dis­ease of the ­lung. Preoperative diag­no­sis was estab­lished ­using com­put­er tomog­ra­phy and ech­o­car­di­og­ra­phy. Postoperatively, two ­patients ­received radio­ther­a­py and one com­bined ­radio-/chem­o­ther­a­py.
Results. One ­patient under­went throm­ben­dar­te­riec­to­my of the ­trunk ­with adju­vant radio­ther­a­py and ­remains ­tumor-­free ­after ­three ­years and one ­showed com­plete regres­sion of metas­ta­ses ­after chem­o­ther­a­py and ­remains ­well ­after ­more ­than one ­year. The oth­er two ­patients ­died with­in two ­months of sur­gery, one due to a ­tumor ­mass in the infe­ri­or ­caval ­vein and the oth­er ­because of cere­bral metas­ta­ses.
Conclusions. According to the lit­er­a­ture, ­mean sur­vi­val ­rate is 1.5 ­months with­out resec­tion and 10 ­months ­with resec­tion, ­with sur­vi­val up to ­four ­years fol­low­ing com­bined resec­tion and adju­vant ther­a­py. Our find­ings are in agree­ment ­with ­this.

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