Thorac cardiovasc Surg 2017; 65(07): 567-571
DOI: 10.1055/s-0036-1583271
Original Thoracic
Georg Thieme Verlag KG Stuttgart · New York

Long-Term Results and Prognostic Factors of Pulmonary Metastasectomy in Patients with Metastatic Transitional Cell Carcinoma

Luca Luzzi1, Giuseppe Marulli2, Piero Solli3, Giuseppe Cardillo4, Marco Ghisalberti1, Marco Mammana2, Francesco Carleo4, Lorenzo Spaggiari5, Federico Rea2
  • 1Thoracic Surgery Unit, University Hospital of Siena, Siena, Italy
  • 2Department of Cardiologic, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
  • 3Department of Thoracic Surgery, Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom
  • 4Unit of Thoracic Surgery, Carlo Forlanini Hospital, Rome, Italy
  • 5Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy
Further Information

Publication History

11 January 2016

18 March 2016

Publication Date:
05 May 2016 (eFirst)


Objective We wanted to assess the prognostic factors and the efficacy of the treatment in patients who underwent lung resections for transitional cell carcinoma metastases.

Materials and Methods This is a retrospective, multicenter study. Between January 1995 and May 2014, 69 patients underwent lung metastasectomy with curative intent. We evaluated primary site of the tumor, the role of adjuvant chemotherapy after urological operation, disease-free interval (DFI; lower or higher than 24 months), type of lung resection, number of lung metastases, presence of metastatic lymph nodes, and diameter of the metastasis (less or more than 3 cm).

Results Among 69 patients, 55 (79%) had bladder as primary site of disease and 12 of them received a transurethral bladder resection. Fourteen (21%) patients developed primary tumor in the renal pelvis or ureter; 53 (76%) patients presented with a single metastasis, 16 (24%) with multiple metastasis. The median DFI was 37 months and the median follow-up was 50 months. Sampling lymphadenectomy was done in 42 patients and nodal metastases were found in 7 patients. The overall 5-year survival was 52%, median 62 months. At univariate analysis, the DFI had a significant impact on survival (5-year survival of 58% for patients with DFI ≥ 24 months vs. 46%; p = 0.048) and diameter of metastasis (5-year survival of 59% for diameter less than 3 cm group vs. 33%; p = 0.001). The multivariate analysis confirmed metastasis' diameter as an independent prognostic factor (p = 0.001).

Conclusion Our study found that, in addition to DFI that remains a common prognostic factor in patients with metastatic lung disease, in lung metastases by transitional cell carcinoma, the diameter of the lesion is another significant prognostic factor.