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THE JOURNAL OF CARDIOVASCULAR SURGERY

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

Copyright © 2009 EDIZIONI MINERVA MEDICA

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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