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Surgical Management of Pulmonary Metastases from Colorectal Cancer in 153 Patients

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Abstract

Background

Surgery has become a recognized therapeutic means in selected patients with pulmonary metastases from colorectal origin. We reviewed our experience in the surgical treatment of 153 patients with pulmonary colorectal metastases and investigated factors affecting survival.

Methods

A retrospective analysis of the records of all patients (n = 153) with pulmonary metastases from colorectal cancer who underwent thoracotomy between 1978 and 2003 at a single surgical center was performed.

Results

One hundred fifty-three patients with pulmonary metastases from colon (n = 61) or rectal (n = 92) cancer underwent 180 thoracotomies. The 2- and 5-year probabilities of survival after the first thoracotomy were 64% and 37%, respectively. Sex, age, site, International Union Against Cancer stage of the primary tumor, prethoracotomy carcinoembryonic antigen level, size of metastases, and previous resection of hepatic metastases were not found to be statistically significant prognostic factors. Number of metastases (solitary vs. multiple), mode of operation (wedge vs. anatomical resection), disease-free interval (DFI; >36 months), negative hilar or mediastinal lymph node status, resection margin >10 mm, and administration of intraoperative blood substitution were predictors of a longer survival duration by univariate analysis, but only number of metastases (P = .019), mode of operation (P = .004), DFI (P = .027), and intraoperative blood substitution (P = .002) were identified as independent prognostic factors by multivariate analysis.

Conclusions

Pulmonary resection for metastases from colorectal cancer is safe and results in long-term survival in selected patients. Single metastases, anatomical resection, intraoperative blood substitution, and DFI >36 months seem to be the most reliable predictors of survival.

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References

  1. Radespiel-Tröger M, Hohenberger W, Reingruber B. Improved prediction of recurrence after curative resection of colon carcinoma using tree-based risk stratification. Cancer 2004; 100:958–67

    Article  PubMed  Google Scholar 

  2. Briester SJ, de Varennes B, Gordon PH, Sheiner NM, Pym J. Contemporary operative management of pulmonary metastases of colorectal origin. Dis Colon Rectum 1988; 31:786–92

    Google Scholar 

  3. McCormack PM, Burt ME, Bains MS, Martini N, Rusch VW, Ginsberg RJ. Lung resection for colorectal metastases. 10-year results. Arch Surg 1992; 127:1403–6

    CAS  Google Scholar 

  4. Shirouzu K, Isomoto H, Hayashi A, Nagamatsu Y, Kakegawa T. Surgical treatment for patients with pulmonary metastases after resection of primary colorectal carcinoma. Cancer 1995; 76:393–8

    Article  CAS  PubMed  Google Scholar 

  5. Goya T, Miyazawa N, Kondo H, Tsuchiya R, Naruke T, Suemasu K. Surgical resection of pulmonary metastases from colorectal cancer. 10-year follow-up. Cancer 1989; 64:1418–21

    Article  CAS  PubMed  Google Scholar 

  6. Thomford NR, Woolner LB, Clagett OT. The surgical treatment of metastatic tumors in the lung. J Thorac Cardiovasc Surg 1965; 49:357–63

    CAS  PubMed  Google Scholar 

  7. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53:457–81

    Article  Google Scholar 

  8. Peto R, Peto J. Asymptomatically efficient rank invariant test procedures. J R Stat Soc A 1972; 135:185–206

    Article  Google Scholar 

  9. Cox DR. Regression models and life tables. J R Stat Soc B 1972; 34:187–220

    Google Scholar 

  10. Sauer R, Becker H, Hohenberger W, et al. German Rectal Cancer Study Group. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 2004; 351:1731–40

    Article  CAS  PubMed  Google Scholar 

  11. Okumura S, Kondo H, Tsuboi M, et al. Pulmonary resection for metastatic colorectal cancer: experiences with 159 patients. J Thorac Cardiovasc Surg 1996; 112:867–74

    Article  CAS  PubMed  Google Scholar 

  12. McAfee MK, Allen MS, Trastek VF, Ilstrup DM, Deschamps C, Pairolero PC. Colorectal lung metastases: results of surgical excision. Ann Thorac Surg 1992; 53:780–6

    Article  CAS  PubMed  Google Scholar 

  13. Girard P, Ducreux M, Baldeyrou P, et al. Surgery for lung metastases from colorectal cancer: analysis of prognostic factors. J Clin Oncol 1996; 14:2047–53

    CAS  PubMed  Google Scholar 

  14. Zanella A, Marchet A, Mainente P, Nitti D, Lise M. Resection of pulmonary metastases from colorectal carcinoma. Eur J Surg Oncol 1997; 23:424–7

    Article  CAS  PubMed  Google Scholar 

  15. Baron O, Amini M, Duveau D, Despins P, Sagan CA, Michaud JL. Surgical resection of pulmonary metastases from colorectal carcinoma. Eur J Cardiothorac Surg 1996; 10:347–51

    Article  CAS  PubMed  Google Scholar 

  16. Inoue M, Ohta M, Iuchi K, et al. Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 2004; 78:238–44

    Article  PubMed  Google Scholar 

  17. Pfannschmidt J, Muley T, Hoffmann H, Dienemann H. Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experience in 167 patients. J Thorac Cardiovasc Surg 2003; 126:732–9

    Article  PubMed  Google Scholar 

  18. Saito Y, Omiya H, Kohno K, et al. Pulmonary metastasectomy for 165 patients with colorectal carcinoma: a prognostic assessment. J Thorac Cardiovasc Surg 2002; 124:1007–13

    Article  PubMed  Google Scholar 

  19. Scheele J, Hofmann, Stangl R, Gall FP. Pulmonary resection for metastatic colon and upper rectum cancer. Is it useful? Dis Colon Rectum 1990; 33:745–52

    Article  CAS  PubMed  Google Scholar 

  20. Vogelsang H, Haas S, Hierholzer C, Berger U, Siewert JR, Präuer H. Factors influencing survival after resection of pulmonary metastases from colorectal cancer. Br J Surg 2004; 91:1066–71

    Article  CAS  PubMed  Google Scholar 

  21. Zink S, Kayser G, Gabius HJ, Kayser K. Survival, disease-free interval, and associated tumor features in patients with colon/rectal carcinomas and their resected intra-pulmonary metastases. Eur J Cardiothorac Surg 2001; 19:908–13

    Article  CAS  PubMed  Google Scholar 

  22. Kanemitsu Y, Kato T, Hirai T, Yasui K. Preoperative probability model for predicting overall survival after resection of pulmonary metastases from colorectal cancer. Br J Surg 2004; 91:112–20

    Article  CAS  PubMed  Google Scholar 

  23. Rena Casadio C, Viano F, Chistofori R, Ruffini E, Filosso PL, Maggi G. Pulmonary resection for metastases from colorectal cancer: factors influencing prognosis. Twenty-year experience. Eur J Cardiothorac Surg 2002; 21:906–12

    Article  Google Scholar 

  24. Pastorino U, Buyse M, Friedel G, et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. J Thorac Cardiovasc Surg 1997; 113:37–49

    Article  Google Scholar 

  25. Scheele J, Altendorf-Hofmann A, Grube T, Hohenberger W, Stangl R, Schmidt K. Resection of colorectal liver metastases: which prognostic factors should govern patient selection? Chirurg 2001; 72:547–60

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of General Surgery, University of Erlangen-Nuremberg, Krankenhausstrasse 12, D-91054, Erlangen, Germany

    Süleyman Yedibela MD, Peter Klein MD, Karsta Feuchter MD, Martin Hoffmann MD, Thomas Meyer MD, Jonas Göhl MD & Werner Hohenberger MD

  2. Institute of Pathology, University of Erlangen-Nuremberg, Krankenhausstrasse 8-10, 91054, Erlangen, Germany

    Thomas Papadopoulos MD

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  1. Süleyman Yedibela MD
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  2. Peter Klein MD
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  3. Karsta Feuchter MD
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  4. Martin Hoffmann MD
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  5. Thomas Meyer MD
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  6. Thomas Papadopoulos MD
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  7. Jonas Göhl MD
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  8. Werner Hohenberger MD
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Correspondence to Süleyman Yedibela MD.

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Yedibela, S., Klein, P., Feuchter, K. et al. Surgical Management of Pulmonary Metastases from Colorectal Cancer in 153 Patients. Ann Surg Oncol 13, 1538–1544 (2006). https://doi.org/10.1245/s10434-006-9100-2

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  • DOI: https://doi.org/10.1245/s10434-006-9100-2

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