Journal of pediatric surgery · 2026
Preoperative computed tomography findings of chest wall or mediastinal invasion in pulmonary metastases among children, adolescents, and young adults.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Shirane Kazuki, Kitagawa Norihiko, Morishima Rento, Takahashi Ryo, Tanaka Satoshi, Kondo Takafumi, Usui Hidehito, Mochizuki Kyoko, Tanaka Mio, Nozawa Kumiko
Аннотация
BACKGROUND: Pulmonary metastasectomy can improve the survival of children with pulmonary metastases from solid tumors. However, preoperative imaging often suggests chest wall and/or mediastinal invasion, raising concerns about resectability. Thus, we aimed to investigate associations between computed tomography (CT) findings and intraoperatively assessed chest wall or mediastinal invasion in children, adolescents, and young adults.
METHODS: We retrospectively reviewed data on pulmonary metastasectomies performed between January 2015 and December 2024. Tumors considered radiographically suspicious for pleural contact or invasion on the most recent preoperative CT scan were included. Tumor invasiveness was classified according to gross intraoperative findings, including adhesion to surrounding structures, pleural thickening, and pleural dissemination.
RESULTS: Fifty-seven metastatic lesions from 26 procedures in 20 patients showed CT findings suggestive of invasion. Based on intraoperative findings, lesions were classified as macroscopically invasive (n =18) or macroscopically non-invasive (n = 39). Multivariate analysis showed that a higher ratio of tumor-pleura contact length to tumor diameter was associated with invasion (p = 0.005; odds ratio, 7.48; 95% confidence interval, 1.83-30.60). However, this association did not reach statistical significance in a mixed-effects logistic regression analysis (p = 0.088).
CONCLUSIONS: In this small retrospective cohort, a higher ratio of tumor-pleura contact length to tumor diameter was associated with intraoperatively assessed macroscopic chest wall or mediastinal invasion in patients undergoing pulmonary metastasectomy. These findings require validation in larger prospective studies.
METHODS: We retrospectively reviewed data on pulmonary metastasectomies performed between January 2015 and December 2024. Tumors considered radiographically suspicious for pleural contact or invasion on the most recent preoperative CT scan were included. Tumor invasiveness was classified according to gross intraoperative findings, including adhesion to surrounding structures, pleural thickening, and pleural dissemination.
RESULTS: Fifty-seven metastatic lesions from 26 procedures in 20 patients showed CT findings suggestive of invasion. Based on intraoperative findings, lesions were classified as macroscopically invasive (n =18) or macroscopically non-invasive (n = 39). Multivariate analysis showed that a higher ratio of tumor-pleura contact length to tumor diameter was associated with invasion (p = 0.005; odds ratio, 7.48; 95% confidence interval, 1.83-30.60). However, this association did not reach statistical significance in a mixed-effects logistic regression analysis (p = 0.088).
CONCLUSIONS: In this small retrospective cohort, a higher ratio of tumor-pleura contact length to tumor diameter was associated with intraoperatively assessed macroscopic chest wall or mediastinal invasion in patients undergoing pulmonary metastasectomy. These findings require validation in larger prospective studies.