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Prognostic factors in pulmonary metastases resection from colorectal cancer: impact of right-sided colon cancer and early recurrence

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Abstract

Objective

This retrospective cohort study aimed to explore the surgical outcomes and prognostic factors of resection of pulmonary metastases (PM) from colorectal cancer (CRC).

Methods

Overall, 60 patients who underwent resection of PM from CRC between 2015 and 2021 at two institutions were reviewed. The primary outcome were overall survival (OS) and early recurrence after PM resection. The association between OS and right-sided colon cancer (RCC) was investigated. Early recurrence after PM resection was defined as recurrence within one year.

Results

The 5-year OS after CRC resection was 83.8% (95% confidence interval [CI] 67.5–92.4) and after PM resection was 69.4% (95% CI 47.5–83.6). In total, 25 patients had recurrence after PM resection (16 within 1 year and 9 after 1 year). In multivariable analysis for OS, RCC (hazard ratio [HR] 4.370, 95% CI 1.020–18.73; p = 0.047) and early recurrence after resection of PM (HR 17.23, 95% CI 2.685–110.6; p = 0.003) were risk factors for poor OS. In multivariable analysis for early recurrence after PM resection, higher value of carcinoembryonic antigen (CEA) (> 5.0 mg/dL) before PM resection was a risk factor for early recurrence (HR 3.275, 95% CI 1.092–9.821; p = 0.034).

Conclusion

The RCC and early recurrence after PM resection were poor prognosis factors of OS. Higher value of CEA before PM resection was an independent risk factor for early recurrence after resection of PM. Comparitive study between surgery and nonsurgery is necessary in patients with higher CEA values.

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Authors and Affiliations

  1. Department of Surgery, The Jikei University Hospital, Nishishinbashi 3-19-18, Minatoku, Tokyo, 105-8471, Japan

    Yo Tsukamoto, Takeo Nakada, Daiki Kato, Takamasa Shibazaki & Takashi Ohtsuka

  2. Department of Surgery, The Jikei University Kashiwa Hospital, 163-1 Kashiwashita Kashiwashi, Chiba, 277-8567, Japan

    Rintaro Shigemori, Shohei Mori & Makoto Odaka

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  1. Yo Tsukamoto
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  2. Takeo Nakada
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  3. Rintaro Shigemori
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  4. Daiki Kato
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  5. Takamasa Shibazaki
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  7. Makoto Odaka
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  8. Takashi Ohtsuka
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Correspondence to Yo Tsukamoto.

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Tsukamoto, Y., Nakada, T., Shigemori, R. et al. Prognostic factors in pulmonary metastases resection from colorectal cancer: impact of right-sided colon cancer and early recurrence. Gen Thorac Cardiovasc Surg (2024). https://doi.org/10.1007/s11748-024-02035-9

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  • DOI: https://doi.org/10.1007/s11748-024-02035-9

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