Is there a role for surgery in the management of metastatic XXXX ? The M. D. Anderson experience.

@entity5 @entity1 @entity66 @entity3
PURPOSE: Although rarely curative, chemotherapy remains the mainstay of treatment for metastatic @entity5 . The role of surgery for metastatic disease is not well established for @entity5 , but is sometimes undertaken in the face of persistent or recurrent disease that can be surgically resected. MATERIALS AND METHODS: We identified 31 @entity1 with metastatic @entity5 undergoing metastasectomy with the intent of rendering them free of disease. All gross disease was completely resected in 30 @entity1 (97%). The most frequently resected location was lung in 24 cases (77%), followed by distant lymph nodes in 4 (13%), brain in 2 (7%) and a subcutaneous @entity3 in 1 (3%). RESULTS: Median survival from diagnosis of @entity3 and from time of metastasectomy was 31 and 23 months, respectively. The 5-year survival from metastasectomy was 33%. Median time to progression following metastasectomy was 7 months. Five @entity1 were @entity66 for more than 3 years after metastasectomy. CONCLUSIONS: The results in this highly selected cohort, with 33% alive at 5 years after metastasectomy, suggest that resection of metastatic disease is feasible and may contribute to long-term disease control especially when integrated with chemotherapy. Further prospective studies should be undertaken to better characterize the selection criteria and benefit from this intervention.
