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Prognosis of video-assisted thoracoscopic pulmonary metastasectomy in patients with colorectal cancer lung metastases: an analysis of 154 cases

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Video-assisted thoracoscopic surgery (VATS) is widely used in thoracic surgery and increasingly applied to pulmonary metastasectomy. The purpose of this study was to identify prognostic factors of patients undergoing VATS pulmonary metastasectomy from colorectal cancer (CRC).

Methods

Between January 2005 and June 2015, a total of 154 patients underwent VATS pulmonary metastasectomy from CRC. Patient demographic data and characteristics of the primary tumor and pulmonary metastasis were analyzed to identify factors significantly correlated with prognosis.

Results

The median follow-up period after pulmonary resection was 37 months. The cumulative 5-year overall survival rate after VATS pulmonary metastasectomy from CRC was 71.3%. History of metastasis to other sites (p = 0.035), status of mediastinal lymph nodes (p < 0.001), and preoperative carcinoembryonic antigen (CEA) level (p = 0.013) were identified as independent prognostic factors. Subgroup analysis with a combination of these three independent prognostic factors revealed 5-year OS rates of 91.0, 70.0, 30.3, and 0.0% for patients with zero, one, two, and three risk factors, respectively. Other factors, such as sex, disease-free interval, T stage of primary tumor, and status of lymph node near the primary tumor, were not significantly associated with prognosis.

Conclusion

VATS pulmonary metastasectomy is efficacious for patients with CRC pulmonary metastases. History of metastasis to other sites, status of mediastinal lymph nodes, and preoperative CEA level were identified as independent prognostic factors. The number of risk factors significantly influenced patient survival.

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Acknowledgements

This study is supported by the Natural Science Foundation of Shanghai, China (Grant No. 14ZR1406000), and the National Natural Science Foundation of China (Grant Nos. 81472225, 81401875). We would like to thank International Science Editing Co. for editing the language.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai, 200032, China

    Fenghao Sun, Li Chen, Mengkun Shi, Xiaodong Yang, Ming Li, Xinyu Yang, Xiyu Dai, Cheng Zhan, Yu Shi & Qun Wang

  2. Eight-Year Program Clinical Medicine, Grade of 2014, Shanghai Medical College, Fudan University, Shanghai, 200032, China

    Ming Li, Xinyu Yang & Xiyu Dai

Authors
  1. Fenghao Sun
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  2. Li Chen
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  3. Mengkun Shi
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  4. Xiaodong Yang
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  5. Ming Li
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  6. Xinyu Yang
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  8. Cheng Zhan
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  9. Yu Shi
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  10. Qun Wang
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Corresponding authors

Correspondence to Cheng Zhan or Yu Shi.

Ethics declarations

The study protocol was approved by the Ethics Committee of Zhongshan Hospital, Fudan University, Shanghai, China (approval no. B2016-189). Written informed consent was obtained from all patients for use of surgical samples and clinical information for medical research.

Additional information

Fenghao Sun and Li Chen contributed equally to this work.

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Sun, F., Chen, L., Shi, M. et al. Prognosis of video-assisted thoracoscopic pulmonary metastasectomy in patients with colorectal cancer lung metastases: an analysis of 154 cases. Int J Colorectal Dis 32, 897–905 (2017). https://doi.org/10.1007/s00384-017-2768-x

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  • DOI: https://doi.org/10.1007/s00384-017-2768-x

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