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Annals of Surgical Oncology

, Volume 23, Issue 3, pp 928–935 | Cite as

Benefit of Adjuvant Chemotherapy After Curative Resection of Lung Metastasis in Colorectal Cancer

  • Hyung Soon Park
  • Minkyu JungEmail author
  • Sang Joon Shin
  • Su Jin Heo
  • Chang Gon Kim
  • Min Goo Lee
  • Seung Hoon Beom
  • Chang Young Lee
  • Jin Gu Lee
  • Dae Joon Kim
  • Joong Bae Ahn
Thoracic Oncology

Abstract

Background

The survival benefit of adjuvant chemotherapy after colorectal cancer (CRC) lung metastasectomy is uncertain.

Methods

We enrolled 221 CRC patients who underwent pulmonary metastasectomy between October 2002 and July 2013, including those with previous liver metastasis that had been curatively resected. Disease-free survival (DFS) and overall survival (OS) were calculated from the day of lung metastasectomy.

Results

Among all patients, 176 (79.6 %) received adjuvant chemotherapy after lung metastasectomy. Median follow-up was 34.7 months from the time of lung metastasectomy [95 % confidence interval (95 % CI), 7.4–90.9 months]. Patients treated with adjuvant chemotherapy had longer DFS compared with surgery alone (median 32.7 vs 11.2 months respectively, P = 0.076). Multivariate analysis revealed previous liver metastasis, preoperative carcinoembryonic antigen ≥5 ng/mL, disease-free interval <24 months, and surgery without adjuvant chemotherapy as independent risk factors for recurrence. Low-risk patients who had 0–1 risk factors received a significant survival benefit from adjuvant chemotherapy [hazard ratio (HR) 0.54; 95 % CI 0.32–0.91, P = 0.020]; however, high-risk patients with ≥2 risk factors did not (HR 1.02; 95 % CI 0.48–2.14, P = 0.964). Patients treated with adjuvant chemotherapy showed no OS benefit compared with patients who received surgery alone (median 89.6 vs 86.8 months respectively, P = 0.833).

Conclusions

CRC patients received lung metastasectomy could have a DFS benefit from adjuvant chemotherapy, especially in low-risk patients. Larger, prospective studies are needed to evaluate the role of adjuvant chemotherapy after CRC lung metastasectomy.

Keywords

Overall Survival Liver Metastasis Adjuvant Chemotherapy Lung Metastasis National Comprehensive Cancer Network 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

We thank Han Na Park (Yonsei Cancer Center, Yonsei University College of Medicine) for her help with data collection.

Conflict of Interest

The authors declare no conflicts of interest.

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Hyung Soon Park
    • 1
  • Minkyu Jung
    • 2
    Email author
  • Sang Joon Shin
    • 2
  • Su Jin Heo
    • 2
  • Chang Gon Kim
    • 2
  • Min Goo Lee
    • 1
  • Seung Hoon Beom
    • 2
  • Chang Young Lee
    • 3
  • Jin Gu Lee
    • 3
  • Dae Joon Kim
    • 3
  • Joong Bae Ahn
    • 2
  1. 1.Department of Pharmacology and Brain Korea 21 Plus Project for Medical SciencesYonsei University College of MedicineSeoulSouth Korea
  2. 2.Division of Medical Oncology, Department of Internal MedicineYonsei University College of MedicineSeoulSouth Korea
  3. 3.Department of Thoracic and Cardiovascular SurgeryYonsei University College of MedicineSeoulSouth Korea

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