Desenlaces clínicos de los pacientes con tumores de célula germinal testiculares llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología entre enero 2010 y enero 2023

Introducción: Los tumores de células germinales (TCG) testiculares son la principal causa de cáncer en hombres entre los 15 y 45 años de edad. El manejo comprende la orquiectomía radical y quimioterapia basada en platino con o sin radioterapia en caso de tumores metastásicos. Se ha reportado enferme...

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Castañeda Motta, Catalina
Tipo de recurso:
https://purl.org/coar/resource_type/c_7a1f
Fecha de publicación:
2023
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
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spa
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https://hdl.handle.net/20.500.12495/13926
Palabra clave:
Tumores de células germinales
Metastasectomía pulmonar
Factores pronosticos
Testicular germ cell tumors
Pulmonary metastasectomy
Prognostic factors
WF 980
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network_name_str Repositorio U. El Bosque
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dc.title.none.fl_str_mv Desenlaces clínicos de los pacientes con tumores de célula germinal testiculares llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología entre enero 2010 y enero 2023
dc.title.translated.none.fl_str_mv Clinical outcomes of patients with testicular germ cell tumors undergoing lung metastasectomy at the Instituto Nacional de Cancerologia between January 2010 and January 2023
title Desenlaces clínicos de los pacientes con tumores de célula germinal testiculares llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología entre enero 2010 y enero 2023
spellingShingle Desenlaces clínicos de los pacientes con tumores de célula germinal testiculares llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología entre enero 2010 y enero 2023
Tumores de células germinales
Metastasectomía pulmonar
Factores pronosticos
Testicular germ cell tumors
Pulmonary metastasectomy
Prognostic factors
WF 980
title_short Desenlaces clínicos de los pacientes con tumores de célula germinal testiculares llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología entre enero 2010 y enero 2023
title_full Desenlaces clínicos de los pacientes con tumores de célula germinal testiculares llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología entre enero 2010 y enero 2023
title_fullStr Desenlaces clínicos de los pacientes con tumores de célula germinal testiculares llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología entre enero 2010 y enero 2023
title_full_unstemmed Desenlaces clínicos de los pacientes con tumores de célula germinal testiculares llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología entre enero 2010 y enero 2023
title_sort Desenlaces clínicos de los pacientes con tumores de célula germinal testiculares llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología entre enero 2010 y enero 2023
dc.creator.fl_str_mv Castañeda Motta, Catalina
dc.contributor.advisor.none.fl_str_mv Carvajal Fierro, Carlos Andrés
Toledo Arenas, José Daniel
dc.contributor.author.none.fl_str_mv Castañeda Motta, Catalina
dc.subject.none.fl_str_mv Tumores de células germinales
Metastasectomía pulmonar
Factores pronosticos
topic Tumores de células germinales
Metastasectomía pulmonar
Factores pronosticos
Testicular germ cell tumors
Pulmonary metastasectomy
Prognostic factors
WF 980
dc.subject.keywords.none.fl_str_mv Testicular germ cell tumors
Pulmonary metastasectomy
Prognostic factors
dc.subject.nlm.none.fl_str_mv WF 980
description Introducción: Los tumores de células germinales (TCG) testiculares son la principal causa de cáncer en hombres entre los 15 y 45 años de edad. El manejo comprende la orquiectomía radical y quimioterapia basada en platino con o sin radioterapia en caso de tumores metastásicos. Se ha reportado enfermedad residual pulmonar posterior a la quimioterapia en el 25%, la metastasectomía pulmonar es esencial en estos casos para excluir actividad residual tumoral. El objetivo de esta investigación fue determinar el pronóstico general de los pacientes con TCG llevados a metastasectomía pulmonar. Metodología: Estudio descriptivo retrospectivo de pacientes llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología (INC) entre 2010 y 2023. Se analizaron las tendencias de los factores pronósticos de estos pacientes. Resultados: Se estudiaron 19 paciente. La supervivencia global (SG) medida a 12 meses fue del 83% y la supervivencia libre de progresión (SLP) a los 12 meses fue del 77%. Se identifico una tendencia hacia los siguientes factores pronósticos: la clasificación pronóstica del Grupo Colaborativo Internacional de Células Germinales (IGCCCG), la histología de la resección posterior a la quimioterapia y el momento de la presentación de la metástasis pulmonar. Conclusiones: La metastasectomía pulmonar después de quimioterapia, en pacientes con TCG testicular, es un procedimiento seguro y eficaz cuyo objetivo es eliminar la enfermedad residual y mejorar la supervivencia
publishDate 2023
dc.date.issued.none.fl_str_mv 2023-12
dc.date.accessioned.none.fl_str_mv 2025-02-11T19:26:41Z
dc.date.available.none.fl_str_mv 2025-02-11T19:26:41Z
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_7a1f
dc.type.local.spa.fl_str_mv Tesis/Trabajo de grado - Monografía - Especialización
dc.type.coar.none.fl_str_mv https://purl.org/coar/resource_type/c_7a1f
dc.type.driver.none.fl_str_mv info:eu-repo/semantics/bachelorThesis
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dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/20.500.12495/13926
dc.identifier.instname.spa.fl_str_mv instname:Universidad El Bosque
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional Universidad El Bosque
dc.identifier.repourl.none.fl_str_mv repourl:https://repositorio.unbosque.edu.co
url https://hdl.handle.net/20.500.12495/13926
identifier_str_mv instname:Universidad El Bosque
reponame:Repositorio Institucional Universidad El Bosque
repourl:https://repositorio.unbosque.edu.co
dc.language.iso.fl_str_mv spa
language spa
dc.relation.references.none.fl_str_mv 1. Kristensena DM, Sonnea SB, Ottesena AM, Perrett RM, Nielsena JE, Almstrupa K, et al. Origin of pluripotent germ cell tumours: The role of microenvironment during embryonic development. Mol Cel Endoc 2008; 288:111–18.
2. Motzer RJ, Jonasch E, Agarwal N, et al. Testicular Cancer. Version 2.2016. In: National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology.
3. Mauricio Medina-Rico y Hugo López-Ramos. Epidemiología del cáncer testicular en países en desarrollo. Revisión de la literatura. Arch. Esp. Urol. 2017; 70 (5): 513-523.
4. José Jaime Correa Ochoaa, Diego Velásquez Ossab, Adrián Ramiro Lopera Torob, Carlos Humberto Martínez Gonzálezc y Andres Yepes Pérez. Guía colombiana de cáncer de testículo. 2016 Publicado por Elsevier España.
5. Hanna NH, Einhorn LH. Testicular cancer--discoveries and updates. N Engl J Med. 2014 Nov 20;371(21):2005-16.
6. Yovany Rodríguez P y Javier I. Godoy. Revista médica Universidad Militar Nueva Granada. 16 (2): 200-214, 2008.
7. D. Nicol (Chair), D. Berney, J.L. Boormans, D. di Nardo (Patient advocate), C.D. Fankhauser, S. Fischer, H. Gremmels (Patient advocate), A. Heidenreich, R. Leão, N. Nicolai, C. Oing, J. Oldenburg, A. Patrikidou, T. Tandstad Guidelines Associates: I. de Angst, W. Cazzaniga, C. Gravina, F. Janisch, Consultant radiologist: Y. Jain Guidelines Office: R. Shepherd. EAU Guidelines on Testicular Cancer. European Association of Urology 2023.
8. Kesler KA, Kruter LE, Perkins SM, et al. Survival after resection for metastatic testicular nonseminomatous germ cell cancer to the lung or mediastinum. Ann Thorac Surg 2011;91:1085–93
9. Liu D, Abolhoda A, Burt ME, et al. Pulmonary metastasectomy for testicular germ cell tumors: a 28-year expe- rience. Ann Thorac Surg 1998;66:1709–14.
10. Einhorn LH, Williams SD, High-Dose Chemotherapy and Stem-Cell Rescue for Metastatic Germ-Cell Tumors. N Engl J Med 2007, 357: 340 – 348
11. José Jaime Correa Ochoaa, Diego Velásquez Ossab, Adrián Ramiro Lopera Torob, Carlos Humberto Martínez Gonzálezc y Andres Yepes Pérez. Guía colombiana de cáncer de testículo. 2016 Publicado por Elsevier Espana
12. Pastorino U, Buyse M, Friedel G, Ginsberg RJ, Girard P, Goldstraw P, Johnston M, McCormack P, Pass H, Putnam Jr JB. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. Journal of Thoracic Cardiovascular Surgery 1997;113(1):37– 49.
13. Boffa DJ, Rusch VW. Surgical techniques for non- seminomatous germ cell tumors metastatic to the lung. Chest Surg Clin of N Am 2002;12:739–48.
14. Pfannschmidt J, Zabeck H, Muley T, Dienemann H, Hoffmann H. Pulmonary metastasectomy following chemotherapy in patients with testicular tumors: experience in 52 patients. Thorac Cardiovasc Surg 2006;54:484-8.
15. Kondo H, Okumura T, Ohde Y, et al. Surgical treatment 68. for metastatic malignancies. Pulmonary metastases:indications and outcomes. Int J Clin Oncol 2005;10:81-5.
16. Alexander J, Haight C. Pulmonary resection for solitary metastatic sarcomas and carcinomas. Surg Gynecol Obstet 1947;85:129—46.
17. Thomford NR, Woolner LB, Clagett OT. The surgical treament of metastatic tumors in the lungs. J Thorac Cardiovasc Surg 1965;49:357—63.
18. Kare Hornbech, Jesper Ravn, Daniel Andreas Steinbruchel. Current status of pulmonary metastasectomy. European Journal of Cardio-thoracic Surgery 39 (2011) 955—962.
19. Loretta Erhunmwunsee, MD, Betty C. Tong, MD, MHS. Preoperative Evaluation and Indications for Pulmonary Metastasectomy. Thorac Surg Clin 26 (2016) 7–12.
20. Ryu Kanzaki, Eriko Fukui, Takashi Kanou, Naoko Ose, Soichiro Funaki, Masato Minami, Yasushi Shintani, Meinoshin Okumura. Preoperative evaluation and indications for pulmonary metastasectomy. Journal of Thoracic Disease 2021;13(4):2590-2602.
21. Krege S et al.European Consensus Conference on Diagnosis and Treatment of Germ Cell Cancer: A Report of the Second Meeting of the European Germ Cell Cancer Consensus Group (EGCCCG): Part II. Europ Urol 2008 53(497–513).
22. Girard P, Baldeyrou P, Le Chevalier T, et al. Surgical resection of pulmonary metastases: up to what number? American Journal of Respiration and Critical Care Medicine 1994; 149:469– 76.
23. Erhunmwunsee L, D’Amico TA. Surgical management of pulmonary metastases. Ann Thorac Surg 2009;88:2052e60.
24. Robert S. Davidsona, Chukwumere E. Nwogub, Mathijs J. Brentjensc, Timothy M. Anderson. The surgical management of pulmonary metastasis: current concepts. Surgical Oncology 10 (2001) 35–42.
25. Monisha Sudarshan, MD, MPH, Sudish C. Murthy, MD, PhD. Current Indications for Pulmonary Metastasectomy. Surg Oncol Clin N Am 29 (2020) 673–683.
26. José Francisco Corona-Cruz, Luis Manuel Domínguez-Parra, David Saavedra-Pérez, Edgardo Jiménez-Fuentes, Cynthia Villarreal-Garza, León Green-Schneeweis, Miguel Ríos-Trejo, Digna Pachuca, Héctor Martínez-Said, Enrique Guzmán-de-Alba, Alejandro Eduardo Padilla- Roscianoa, Oscar Arrieta. Lung metastasectomy: Long-term outcomes in an 18-year cohort from a single center. Surgical Oncology 21 (2012) 237e244.
27. M Schnorrer, D Ondrus, B Vichova, M Oravsky, V Bak. Surgical treatment of pulmonary metastases in germ-cell testicular cancer patients--long-term results. Bratislava Medical Journal 2009;110(10):620-2.
28. Steverberg EW, Keizer HJ, Messemer JE, et al. Residual pulmonary masses after chemotherapy for metastatic non- seminomatous germ cell tumor. Prediction of histology. ReHiT Study Group. Cancer 1997;79:345–5.
29. Kollmannsberger C, Daneshmand S, So A, et al. Manage- ment of disseminated nonseminomatous germ cell tumors with risk-based chemotherapy followed by response- guided postchemotherapy surgery. J Clin Oncol 2010;28: 537–42.
30. Besse B, Grunenwald D, Flechon A, et al. Non- seminomatous germ cell tumors: assess the need for post- chemotherapy contralateral pulmonary resection in patients with ipsilateral complete necrosis. J Thorac Cardiovasc Surg 2009;137:448–52.
31. Fizazi K, Tjulandin S, Salvioni R, et al. Viable malignant cells after primary chemotherapy for disseminated non- seminomatous germ cell tumors: prognostic factors and role of postsurgery chemotherapy-results from an international study group. J Clin Oncol 2001;19:2647–57.
32. Kesler KA, Wilson JL, Cosgrove JA, et al. Surgical “salvage” therapy for malignant intrathoracic metastases from non- seminomatous germ cell cancer of testicular origin: analysis of a single institution experience. J Thorac Cardiovasc Surg 2005;130:408–15
33. Ercan S, Nichols FC, 3rd, Trastek VF, et al. Prognostic significance of lymph node metastasis found during pulmonary metastasectomy for extrapulmonary carcinoma. Ann Thorac Surg 2004;77:1786–91.
34. Garcia-Yuste M, Cassivi S, Paleru C. Thoracic lymphatic involvement in patients having pulmonary metastasectomy: incidence and the effect on prognosis. J Thorac Oncol 2010;5(Suppl 2):S166–9
35. Seebacher G, Decker S, Fischer JR, Held M, Scha€fers HJ, Graeter TP. Unexpected lymph node disease in resections for pulmonary metastases. Ann Thorac Surg 2015;99:231–6.
36. Winter H, Meimarakis G, Angele MK, et al. Tumor infiltrated hilar and mediastinal lymph nodes are an independent prognostic factor for decreased survival after pulmonary metastasectomy in patients with renal cell carcinoma. J Urol 2010;184:1888–94.
37. Casiraghi M, De Pas T, Maisonneuve P, Brambilla D, Ciprandi B, Galetta D, et al. A 10-year single-center experience in 708 lung metastasectomies. The evidence of the “International Registry of Lung Metastases”. J Thorac Oncol 2011;6:1373e8
38. Jaklitsch MT, Mery CM, Lukanich JM, Richards WG, Bueno R, Swanson SJ, Mentzer SJ, Davis BD, Allred EN, Sugarbaker DJ. Sequential thoracic metastasectomy prolongs survival by re-establishing local control within the chest. J Thorac Cardiovasc Surg 2001;121:657—67.
39. Tanaka Y, Maniwa Y, Nishio W, et al. The optimal timing to resect pulmonary metastases. Eur J Cardiothorac Surg 70. 2008;33:1135-8.
40. Krüger M, Schmitto JD, Wiegmann B, et al. Optimal timing of pulmonary metastasectomy--is a delayed 71. operation beneficial or counterproductive? Eur J Surg Oncol 2014;40:1049-55.
41. Abecasis N, Cortez F, Bettencourt A, Costa CS, Orvalho F, Mendez de Almeida JM. Surgical treatment of lung metastases: prognostic factors for long-term survival. Journal of Surgical Oncology 1999;72:193–8.
42 Kenneth A. Kesler, MD,a Jamison L, et al. Surgical salvage therapy for malignant intrathoracic metastases from nonseminomatous germ cell cancer of testicular origin: Analysis of a single-institution experience. J Thorac Cardiovasc Surg. 2005 Aug;130(2):408-15.
43. Federico Raveglia, Lorenzo Rosso, et al. Pulmonary metastasectomy in germ cell tumors and prostate cancer. Journal of Thoracic Disease 2021;13(4):2661-2668.
44. Joachim Schirren, Stephan Trainer, et al. The Role of Residual Tumor Resection in the Management of Nonseminomatous Germ Cell Cancer of Testicular Origin. Thorac Cardiovasc Surg 2012;60:405–412.
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spelling Carvajal Fierro, Carlos AndrésToledo Arenas, José DanielCastañeda Motta, Catalina2025-02-11T19:26:41Z2025-02-11T19:26:41Z2023-12https://hdl.handle.net/20.500.12495/13926instname:Universidad El Bosquereponame:Repositorio Institucional Universidad El Bosquerepourl:https://repositorio.unbosque.edu.coIntroducción: Los tumores de células germinales (TCG) testiculares son la principal causa de cáncer en hombres entre los 15 y 45 años de edad. El manejo comprende la orquiectomía radical y quimioterapia basada en platino con o sin radioterapia en caso de tumores metastásicos. Se ha reportado enfermedad residual pulmonar posterior a la quimioterapia en el 25%, la metastasectomía pulmonar es esencial en estos casos para excluir actividad residual tumoral. El objetivo de esta investigación fue determinar el pronóstico general de los pacientes con TCG llevados a metastasectomía pulmonar. Metodología: Estudio descriptivo retrospectivo de pacientes llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología (INC) entre 2010 y 2023. Se analizaron las tendencias de los factores pronósticos de estos pacientes. Resultados: Se estudiaron 19 paciente. La supervivencia global (SG) medida a 12 meses fue del 83% y la supervivencia libre de progresión (SLP) a los 12 meses fue del 77%. Se identifico una tendencia hacia los siguientes factores pronósticos: la clasificación pronóstica del Grupo Colaborativo Internacional de Células Germinales (IGCCCG), la histología de la resección posterior a la quimioterapia y el momento de la presentación de la metástasis pulmonar. Conclusiones: La metastasectomía pulmonar después de quimioterapia, en pacientes con TCG testicular, es un procedimiento seguro y eficaz cuyo objetivo es eliminar la enfermedad residual y mejorar la supervivenciaInstituto Nacional de CancerologíaEspecialista en Cirugía del TóraxEspecializaciónIntroduction: Testicular germ cell tumors (GCTs) are the main cause of cancer in men between 15 and 45 years old. Management includes radical orchiectomy and platinum-based chemotherapy with or without radiotherapy in the case of metastatic tumors. Residual lung disease after chemotherapy has been reported in 25% of cases, and lung metastasectomy is essential in these cases to exclude residual tumor activity. The aim of this investigation was to determine the general prognosis of patients with GCTs undergoing lung metastasectomy. Methodology: Retrospective descriptive study of patients undergoing lung metastasectomy at the Instituto Nacional de Cancerologia (INC) between 2010 and 2023. Trends in prognostic factors in these patients were analyzed. Results: 19 patients were included. Overall survival (OS) measured at 12 months was 83% and progression-free survival (PFS) at 12 months was 77%. A trend towards the following prognostic factors was identified: the International Germ Cell Collaborative Group (IGCCCG) prognostic classification, the histology of the post-chemotherapy resection and the time of presentation of the pulmonary metastasis. Conclusions: Pulmonary metastasectomy after chemotherapy in patients with testicular GCT is a safe and effective procedure aimed at eliminating residual disease and improving survival.application/pdfTumores de células germinalesMetastasectomía pulmonarFactores pronosticosTesticular germ cell tumorsPulmonary metastasectomyPrognostic factorsWF 980Desenlaces clínicos de los pacientes con tumores de célula germinal testiculares llevados a metastasectomía pulmonar en el Instituto Nacional de Cancerología entre enero 2010 y enero 2023Clinical outcomes of patients with testicular germ cell tumors undergoing lung metastasectomy at the Instituto Nacional de Cancerologia between January 2010 and January 2023Especialización en Cirugía del TóraxUniversidad El BosqueFacultad de MedicinaTesis/Trabajo de grado - Monografía - Especializaciónhttps://purl.org/coar/resource_type/c_7a1fhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesishttps://purl.org/coar/version/c_ab4af688f83e57aa1. Kristensena DM, Sonnea SB, Ottesena AM, Perrett RM, Nielsena JE, Almstrupa K, et al. Origin of pluripotent germ cell tumours: The role of microenvironment during embryonic development. Mol Cel Endoc 2008; 288:111–18.2. Motzer RJ, Jonasch E, Agarwal N, et al. Testicular Cancer. Version 2.2016. In: National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology.3. Mauricio Medina-Rico y Hugo López-Ramos. Epidemiología del cáncer testicular en países en desarrollo. Revisión de la literatura. Arch. Esp. Urol. 2017; 70 (5): 513-523.4. José Jaime Correa Ochoaa, Diego Velásquez Ossab, Adrián Ramiro Lopera Torob, Carlos Humberto Martínez Gonzálezc y Andres Yepes Pérez. Guía colombiana de cáncer de testículo. 2016 Publicado por Elsevier España.5. Hanna NH, Einhorn LH. Testicular cancer--discoveries and updates. N Engl J Med. 2014 Nov 20;371(21):2005-16.6. Yovany Rodríguez P y Javier I. Godoy. Revista médica Universidad Militar Nueva Granada. 16 (2): 200-214, 2008.7. D. Nicol (Chair), D. Berney, J.L. Boormans, D. di Nardo (Patient advocate), C.D. Fankhauser, S. Fischer, H. Gremmels (Patient advocate), A. Heidenreich, R. Leão, N. Nicolai, C. Oing, J. Oldenburg, A. Patrikidou, T. Tandstad Guidelines Associates: I. de Angst, W. Cazzaniga, C. Gravina, F. Janisch, Consultant radiologist: Y. Jain Guidelines Office: R. Shepherd. EAU Guidelines on Testicular Cancer. European Association of Urology 2023.8. Kesler KA, Kruter LE, Perkins SM, et al. Survival after resection for metastatic testicular nonseminomatous germ cell cancer to the lung or mediastinum. Ann Thorac Surg 2011;91:1085–939. Liu D, Abolhoda A, Burt ME, et al. Pulmonary metastasectomy for testicular germ cell tumors: a 28-year expe- rience. Ann Thorac Surg 1998;66:1709–14.10. Einhorn LH, Williams SD, High-Dose Chemotherapy and Stem-Cell Rescue for Metastatic Germ-Cell Tumors. N Engl J Med 2007, 357: 340 – 34811. José Jaime Correa Ochoaa, Diego Velásquez Ossab, Adrián Ramiro Lopera Torob, Carlos Humberto Martínez Gonzálezc y Andres Yepes Pérez. Guía colombiana de cáncer de testículo. 2016 Publicado por Elsevier Espana12. Pastorino U, Buyse M, Friedel G, Ginsberg RJ, Girard P, Goldstraw P, Johnston M, McCormack P, Pass H, Putnam Jr JB. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. Journal of Thoracic Cardiovascular Surgery 1997;113(1):37– 49.13. Boffa DJ, Rusch VW. Surgical techniques for non- seminomatous germ cell tumors metastatic to the lung. Chest Surg Clin of N Am 2002;12:739–48.14. Pfannschmidt J, Zabeck H, Muley T, Dienemann H, Hoffmann H. Pulmonary metastasectomy following chemotherapy in patients with testicular tumors: experience in 52 patients. Thorac Cardiovasc Surg 2006;54:484-8.15. Kondo H, Okumura T, Ohde Y, et al. Surgical treatment 68. for metastatic malignancies. Pulmonary metastases:indications and outcomes. Int J Clin Oncol 2005;10:81-5.16. Alexander J, Haight C. Pulmonary resection for solitary metastatic sarcomas and carcinomas. Surg Gynecol Obstet 1947;85:129—46.17. Thomford NR, Woolner LB, Clagett OT. The surgical treament of metastatic tumors in the lungs. J Thorac Cardiovasc Surg 1965;49:357—63.18. Kare Hornbech, Jesper Ravn, Daniel Andreas Steinbruchel. Current status of pulmonary metastasectomy. European Journal of Cardio-thoracic Surgery 39 (2011) 955—962.19. Loretta Erhunmwunsee, MD, Betty C. Tong, MD, MHS. Preoperative Evaluation and Indications for Pulmonary Metastasectomy. Thorac Surg Clin 26 (2016) 7–12.20. Ryu Kanzaki, Eriko Fukui, Takashi Kanou, Naoko Ose, Soichiro Funaki, Masato Minami, Yasushi Shintani, Meinoshin Okumura. Preoperative evaluation and indications for pulmonary metastasectomy. Journal of Thoracic Disease 2021;13(4):2590-2602.21. 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