Abstract:
INTRODUCTION:Autopsy studies of persons who died of cancer have shown the lungs to be the sole site of metastasis in about 20% of cases. The resection of pulmonary metastases is indicated for palliative purposes if they contain a large volume of necrotic tumor, infiltrate the thoracic wall to produce pain, or cause hemoptysis or retention pneumonia. Metastasectomy with curative intent may be indicated for carefully selected patients. METHODS:This review is based on a selective search of the PubMed database for articles that were published from 2006 to 2011 and contained the keywords "pulmonary metastasectomy," "lung resection of metastasis," and "lung metastasectomy." RESULTS:No prospective comparative trials have been performed to date that might provide evidence for prolongation of survival by pulmonary metastasectomy; nor have there been any randiomized, controlled trials yielding evidence that would assist in the decision whether to treat pulmonary metastases with surgery, radiotherapy, or chemotherapy (or some combination of these). The indication for surgery is a function of the histology of the primary tumor, the number and location of metastases, the lung capacity that is expected to remain after surgery, and the opportunity for an R0 resection. Favorable prognostic factors include a long disease-free interval between the treatment of the primary tumor and the discovery of pulmonary metastases, the absence of thoracic lymph node metastases, and a small number of pulmonary metastases. The reported 5-year survival rates after pulmonary metastasectomy, depending on the primary tumor, are 35.5% to 47% for renal-cell carcinoma, 39.1% to 67.8% for colorectal cancer, 29% to 52% for soft-tissue sarcoma, 38% to 49.7% for osteosarcoma, and 79% to 94% for non-seminomatous germ-cell tumors. For the latter two types of tumor, chemotherapy is the most beneficial form of treatment for long-term survival. CONCLUSION:When there is no good clinical alternative, the resection of pulmonary metastases can give some patients long-lasting freedom from malignant disease. Patients should be carefully selected on the basis of clinical staging with defined prognostic indicators.
journal_name
Dtsch Arztebl Intjournal_title
Deutsches Arzteblatt internationalauthors
Pfannschmidt J,Egerer G,Bischof M,Thomas M,Dienemann Hdoi
10.3238/arztebl.2012.0645subject
Has Abstractpub_date
2012-10-01 00:00:00pages
645-51issue
40issn
1866-0452journal_volume
109pub_type
杂志文章,评审abstract:BACKGROUND:Otitis externa has a lifetime prevalence of 10% and can arise in acute, chronic, and necrotizing forms. METHODS:This review is based on publications retrieved by a selective search of the pertinent literature. RESULTS:The treatment of acute otitis media consists of anal- gesia, cleansing of the external au...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2019.0224
更新日期:2019-03-29 00:00:00
abstract:BACKGROUND:The introduction of neurological stroke units and of thrombolysis with the intravenous (IV) administration of recombinant tissue-type plasminogen activator (tPA) have markedly improved the treatment of stroke. Five randomized trials of catheter-based interventional treatment of stroke with special stents wer...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2015.0830
更新日期:2015-12-04 00:00:00
abstract:BACKGROUND:Atrial fibrillation is the most common type of cardiac arrhythmia and is associated with elevated rates of stroke, heart failure, hospital admission, and death. Its prevalence in the overall population is 1.5% to 2%. To convert atrial fibrillation to sinus rhythm, cardioversion is needed. METHODS:This revie...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2015.0856
更新日期:2015-12-11 00:00:00
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journal_title:Deutsches Arzteblatt international
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
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abstract:BACKGROUND:In this study, we investigated the measures currently being taken in German hospitals to prevent infection with methicillin-resistant strains of Staphylococcus aureus (MRSA). To this end, we circulated a questionnaire among hospitals participating in the MRSA-KISS module. "KISS" in the name of this project s...
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更新日期:2010-09-01 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2017.0161
更新日期:2017-03-10 00:00:00
abstract:BACKGROUND:Some hematological malignancies arise in persons with a hereditary predisposition. The hereditary nature of these diseases often goes unrecognized, particularly when symptoms begin in adulthood. METHODS:This review is based on pertinent publications retrieved by a selective search in PubMed. RESULTS:Many r...
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更新日期:2018-12-14 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,meta分析,评审
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更新日期:2016-01-22 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.3238/arztebl.2016.0741
更新日期:2016-11-04 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2013.0085
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Breast cancer is the most common cancer in women. The German S3 guideline of 2012 has now been updated to take account of advances in the early detection, diagnostic evaluation, treatment, and follow-up care of this disease. METHODS:The updating process was based on the adaptation of identified source guide...
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pub_type: 杂志文章
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更新日期:2018-05-04 00:00:00
abstract::[This corrects the article DOI: 10.3238/arztebl.2017.0661.]. ...
journal_title:Deutsches Arzteblatt international
pub_type: 已发布勘误
doi:10.3238/arztebl.2017.0752
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Optimizing the emergency medical care chain might shorten the time to treatment of patients with ST-elevation myocardial infarction (STEMI). The initial care by a physician, and, in particular, correct ECG interpretation, are critically important factors. METHODS:From 1999 onward, data on the care of patien...
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pub_type: 杂志文章
doi:10.3238/arztebl.2016.0497
更新日期:2016-07-25 00:00:00
abstract:BACKGROUND:When gunshot and blast injuries affect only a single person, first aid can always be delivered in conformity with the relevant guidelines. In contrast, when there is a dynamic casualty situation affecting many persons, such as after a terrorist attack, treatment may need to be focused on immediately life-thr...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2017.0237
更新日期:2017-04-07 00:00:00
abstract:INTRODUCTION:Intermittent paradoxical closure of the vocal cords can induce major attacks of dyspnea. Such attacks, called "vocal cord dysfunction" (VCD), are an important element in the differential diagnosis of intractable bronchial asthma. METHODS:Selective review of the literature. RESULTS:The etiology of VCD is ...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0699
更新日期:2008-10-01 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
doi:10.3238/arztebl.2011.0687
更新日期:2011-10-01 00:00:00
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pub_type: 杂志文章
doi:10.3238/arztebl.2015.0527
更新日期:2015-08-03 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
doi:10.3238/arztebl.2008.0055
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:In endocrine orbitopathy (EO), disfiguring proptosis and diplopia impair patients' quality of life both at home and at work. METHODS:From late 2006 to the beginning of 2008, 250 outpatients in an interdisciplinary thyroid and eye clinic filled out a questionnaire about their quality of life, occupational di...
journal_title:Deutsches Arzteblatt international
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更新日期:2009-04-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2020-06-19 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2015-10-16 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,meta分析,评审
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更新日期:2016-02-05 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2014-08-04 00:00:00
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更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Psychiatric emergencies such as acute psychomotor agitation or suicidality often arise in non-psychiatric settings such as general hospitals, emergency services, or doctors' offices and give rise to stress for all persons involved. They may be life-threatening and must therefore be treated at once. In this a...
journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章,评审
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更新日期:2011-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2011-12-01 00:00:00
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journal_title:Deutsches Arzteblatt international
pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00