Survival prognostic and recurrence risk factors after single pulmonary metastasectomy.

<bold>Background: </bold>Identification of the prognostic factors of recurrence and survival after single pulmonary metastasectomy (PM).<bold>Methods: </bold>Retrospective analysis of all consecutive patients who underwent PM for a single lung metastasis between 2003 and 2018.<bold>Results: </bold>A total of 162 patients with a median age of 64 years underwent single PM. Video-Assisted Thoracic Surgery (VATS) was performed in 83.9% of cases. Surgical resection was achieved by wedge in 73.5%, segmentectomy in 7.4%, lobectomy in 17.9% and pneumonectomy in 1.2% of cases. The median durations of hospital stay and of drainage were 4 days (IQR 3-7) and 1 day (IQR 1-2), respectively. During the follow-up (median 31 months; IQR 15-58), 93 patients (57.4%) presented recurrences and repeated PM could be realized in 35 patients (21.6%) achieved by VATS in 77.1%. Non-colorectal tumour (HR 1.84), age < 70 years (HR 1.77) and previous extra-thoracic metastases (HR 1.61) were identified as prognostic factors of recurrence. Overall survival at 5-year was estimated at 67%. Non-colorectal tumour (HR 2.40) and mediastinal lymph nodes involvement (HR 3.42) were significantly associated with an increased risk of death.<bold>Conclusions: </bold>Despite high recurrence rates after PM, surgical resection shows low morbidity rate and acceptable long-term survival, thus should remain the standard treatment for single pulmonary metastases.<bold>Trial Registration: </bold>The Local Ethics Committee approved the study (No. 2019-02,474) and individual consent was waived. [ABSTRACT FROM AUTHOR]