Pulmonary metastasis in newly diagnosed colon-rectal cancer: a population-based nomogram study

  • Yiwei Huang
  • Mengnan Zhao
  • Jiacheng Yin
  • Tao Lu
  • Xiaodong Yang
  • Guangda Yuan
  • Ming Li
  • Yu Liu
  • Cheng ZhanEmail author
  • Qun WangEmail author
Original Article



Colorectal cancer (CRC) has a high worldwide incidence with a tendency to metastasize to the lungs. We aimed to identify clinical factors related to lung metastasis (LM) and analyze the prognosis of patients after LM.


Multivariate logistic regression analysis was used to identify risk factors for LM from CRC. Univariate and multivariate Cox proportional hazard models were performed to identify potentially important prognostic factors for patients with LM.


Age (p = 0.010), tumor size (p < 0.001), T stage (p < 0.001), N stage (p < 0.001), race (p < 0.001), tumor site (p < 0.001), liver metastasis (p < 0.001), brain metastasis (p < 0.001), bone metastasis (p < 0.001), serum levels of carcinoembryonic antigen (CEA) (p < 0.001), and circumferential resection margin (CRM) (p < 0.001) were associated with a risk of LM from CRC. All factors (all, p < 0.001) except tumor size (p = 0.095) and race (p = 0.650) were related to the overall survival of patients. Two nomograms were formulated to visually predict lung metastasis risk and 1-, 3-, and 5- year overall survivals for patients with LM. The concordance indices were 0.754 and 0.749, respectively.


Age, tumor size, histological grade, serum levels of CEA, tumor site, surgery modalities of CRC, CRM, number of positive lymph nodes, and chemotherapy were independent risk factors for LM from CRC. The nomograms we developed can be effectively used to forecast the risk of LM and predict the survival for LM from CRC.


Colorectal cancer Pulmonary metastasis Risk factors Prognosis Nomogram 



We thank the International Science Editing Co. for editing the language.

Funding information

This work was supported by the National Natural Science Foundation of China (Grant Number 81672268) []).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

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Supplementary Figure 1

Survival analyses for all patients and patients with lung metastasis. (PNG 134 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Yiwei Huang
    • 1
  • Mengnan Zhao
    • 1
  • Jiacheng Yin
    • 1
  • Tao Lu
    • 1
  • Xiaodong Yang
    • 1
  • Guangda Yuan
    • 2
  • Ming Li
    • 3
  • Yu Liu
    • 1
  • Cheng Zhan
    • 1
    Email author
  • Qun Wang
    • 1
    Email author
  1. 1.Department of Thoracic Surgery, Zhongshan HospitalFudan UniversityShanghaiChina
  2. 2.Department of Thoracic SurgeryThe Affiliated Suzhou Hospital of Nanjing Medical UniversitySuzhouChina
  3. 3.Eight-year Program Clinical Medicine, Shanghai Medical CollegeFudan UniversityShanghaiChina

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