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Surgical treatment of synchronous and metachronous hepatic–and pulmonary colorectal cancer metastases —the Copenhagen experience

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Summary

Background

The surgical treatment of patients with isolated colorectal hepatic- or pulmonary metastases is well established with a 5-year survival in the range of 40–50 %. In contrast the treatment of patients with both hepatic- and pulmonary metastases remains controversial. We here present our initial results of patients who underwent both hepatic- and pulmonary resections for colorectal metastases with emphasis on post-operative complications and long-term survival.

Methods

The files of patients with metastasising colorectal cancer who underwent both hepatic- and pulmonary metastasectomy during 2003–2010 were reviewed retrospectively. Estimated overall survival and 1-, 3-, and 5-year survival rates were calculated by the method of Kaplan Meier. The log-rank test was used to compare patients survival for synchronous and metachronous metastases. A p value < 0.05 was considered significant.

Results

Nineteen patients were identified (9F/10M) with a median age of 63 years. Ten patients (53 %) presented with synchronous metastases and nine patients (47 %) with metachronous metastases. Only minor medical- and surgical complications were reported subsequent surgery. The 30-day mortality was zero. From time of resection of the primary colorectal tumour the estimated 5-year survival rate was 48.5 % with a median survival of 47 months. There were no difference in long-term survival between synchronous and metachronous metastases (p> 0.05).

Conclusions

The present study has demonstrated that resection of both hepatic and pulmonary colorectal metastases is safe and good long-term outcome can be obtained for selected patients. Thus, an aggressive surgical approach to patients with synchronous or metachronous hepatic and pulmonary metastases seems justified.

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Conflict of interest

The authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Peter Stemann Andersen MD, Peter Nørgaard Larsen MD & Andre Wettergren dr.med

  2. Department of Cardiothoracic Surgery, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Kåre Hornbech MD & Jesper Ravn MD

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  1. Peter Stemann Andersen MD
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  2. Kåre Hornbech MD
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  3. Peter Nørgaard Larsen MD
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  4. Jesper Ravn MD
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  5. Andre Wettergren dr.med
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Correspondence to Peter Stemann Andersen MD.

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Andersen, P., Hornbech, K., Larsen, P. et al. Surgical treatment of synchronous and metachronous hepatic–and pulmonary colorectal cancer metastases —the Copenhagen experience. Eur Surg 44, 400–407 (2012). https://doi.org/10.1007/s10353-012-0174-8

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  • DOI: https://doi.org/10.1007/s10353-012-0174-8

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