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Clinical outcomes following colorectal resection of colorectal cancer with simultaneous hepatic and pulmonary metastases at the time of diagnosis

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Abstract

Purpose

There are no established treatment strategies for patients with hepatic and pulmonary metastases at the time of primary colorectal cancer (CRC) diagnosis. This study assessed patients undergoing complete resection of primary CRC and hepatic and pulmonary metastases, to evaluate long-term outcomes and clarify clinicopathological factors associated with failure of complete resection.

Methods

This retrospective analysis enrolled patients at Shizuoka Cancer Center between 2002 and 2018 who underwent colorectal resection with curative intent for primary CRC with hepatic and pulmonary metastases. The curative resection (CR) group comprised patients who underwent complete resection of the primary tumor and metastatic lesions, and the non-curative resection (Non-CR) group consisted of those in whom resection of the metastatic lesions was not performed. Univariate and multivariate analyses were conducted to determine clinicopathological factors associated with non-curative resection.

Results

Of 26 total patients, the CR and Non-CR groups consisted of 14 (54%) and 12 patients (46%), respectively. In the CR group, the 3-year overall and relapse-free survival rates were 92.9% and 28.6%, respectively. Multivariate analysis showed that pathological stage T4 (odds ratio 8.58, 95% confidence interval 1.13–65.20, p = 0.04) was independently associated with non-curative resection.

Conclusion

The percentage of patients undergoing complete resection of primary CRC and metastatic lesions was 56%, and the 3-year OS rate was 92.9%. Resection of primary CRC and metastatic lesions was considered to be appropriate in this population, and pathological stage T4 tumor was associated with incomplete resection of metastatic tumors.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials.

Code availability

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Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Yusuke Tanaka, Yusuke Yamaoka, Akio Shiomi, Hiroyasu Kagawa, Hitoshi Hino, Shoichi Manabe, Kai Chen & Kenji Nanishi

  2. Clinical Research Center, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan

    Akifumi Notsu

Authors
  1. Yusuke Tanaka
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  2. Yusuke Yamaoka
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  3. Akio Shiomi
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  4. Hiroyasu Kagawa
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  5. Hitoshi Hino
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  6. Shoichi Manabe
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  7. Kai Chen
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  8. Kenji Nanishi
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  9. Akifumi Notsu
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Contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by Yusuke Tanaka, Yusuke Yamaoka, Akio Shiomi, Hiroyasu Kagawa, Hitoshi Hino, Shoichi Manabe, and Akifumi Notsu. The first draft of the manuscript was written by Yusuke Tanaka and Yusuke Yamaoka, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Yusuke Yamaoka.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Shizuoka Cancer Center (institutional code: J2020-75–2020-1–3).

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Informed consent was obtained from all individual participants included in this study.

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The authors declare no competing interests.

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Tanaka, Y., Yamaoka, Y., Shiomi, A. et al. Clinical outcomes following colorectal resection of colorectal cancer with simultaneous hepatic and pulmonary metastases at the time of diagnosis. Langenbecks Arch Surg 407, 759–768 (2022). https://doi.org/10.1007/s00423-021-02385-5

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