Is Laser-Assisted Resection a Viable Alternative to Pulmonary Metastasectomy in Sarcoma?

12/20/17

A recent study compared the effects of laser-assisted resection with pulmonary metastasectomy in patients with extrathoracic sarcoma, published online in the Journal of Thoracic Disease.

Prior research has shown a survival benefit for patients with extrathoracic sarcoma after undergoing pulmonary metastasectomy. In recent years, surgeons have begun seeking different techniques for treating such disease. Laser-assisted surgery has been considered one of the cutting edge surgical options, but further research is necessary to validate its effectiveness.

A group of international researchers conducted a study to compare the effects of laser-assisted resection with pulmonary metastasectomy in patients with extrathoracic sarcoma. Researchers sampled data from a prospectively maintained institutional database. A total of 83 patients who underwent pulmonary metastasectomy in the last 11 years were identified. Contrarily, a total of 106 cases were considered for comparative purposes, 46 of which demonstrated laser-assisted resection and 60 of which demonstrated conventional resection.

Researchers reported that significantly more metastases were resected in the laser-assisted resection group compared with the conventional group (median, interquartile range: 6.5 (2.0–11.0) vs. 1.0 (1.0–3.5); P < .0001]. However, the number of tumor recurrences were similar in both groups [64% tumor recurrences in the laser-assisted resection group and 58% in the conventional group; odds ratio, 1.3; P = .6].

Furthermore, researchers reported that overall survival was comparable; median survival was 77.6 and 29.0 months and 2- and 5-year survival rates were 71% and 63% as well as 53% and 36% in the respective cohorts (hazard ratio, 0.74; P = .43].

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In their concluding remarks, researchers reported that using laser-assisted resection can aid in removing a significantly higher number of metastases while producing similar long-term outcomes as conventional techniques in extrathoracic sarcoma. “Future studies will have to evaluate possible advantages provided by laser-assisted resection in a prospective manner,” they wrote.—Zachary Bessette