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Long-term outcomes and early recurrence after resection for metachronous pulmonary metastases from colorectal cancer

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Abstract

Purpose

Properly selecting patients for aggressive curative resection for pulmonary metastases (PMs) from colorectal cancer (CRC) is desirable. We purposed to clarify prognostic factors and risk factors for early recurrence after metachronous PM resection.

Methods

Clinical data of 151 patients who underwent R0 resection for metachronous PMs from CRC at two institutions between 2008 and 2021 were reviewed.

Results

Seventy-six patients (50.3%) were male, and the median age was 71 (42–91) years. The numbers of colon/rectal cancers were 76/75, with pStage I/II/III/IV/unknown in 15/34/86/13/3. The duration from primary surgery to PM was 19.7 (1.0–106.4) months. The follow-up period was 41.9 (0.3–156.2) months. The 1-, 3-, and 5-year recurrence-free survival (RFS) rates were 75.1%, 53.7%, and 51.1%, and the 1-, 3-, and 5-year overall survival (OS) rates were 97.7%, 87.5%, and 68.2%. On multivariate analysis, lymph node metastasis of the primary lesion (HR 1.683, 95%CI 1.003–2.824, p = 0.049) was an independent predictor of poor RFS, and history of resection for extrapulmonary metastasis (e-PM) (HR 2.328, 95%CI 1.139–4.761, p = 0.021) was an independent predictor of poor OS. Patients who experienced early recurrence (< 6 months) after PM resection showed poorer OS than others (3-year OS 50.8% vs. 90.2%, p = 0.002). On multivariate analysis, e-PM was an independent predictor of early recurrence after PM resection (OR 3.989, 95%CI 1.002–15.885, p = 0.049).

Conclusion

Since a history of e-PM was a predictor of early recurrence and poor OS after R0 resection for PM, surgical treatment of patients with a history of e-PM should be considered carefully.

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Data availability

The data that support the findings of this study are available from the corresponding author, upon reasonable request.

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Authors and Affiliations

  1. Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 852-8511, Japan

    Shintaro Hashimoto, Tetsuro Tominaga, Takashi Nonaka, Keisuke Noda, Toshio Shiraishi, Kaido Oishi, Yuma Takamura, Takuro Miyazaki, Ryotaro Kamohara, Keitaro Matsumoto & Takeshi Nagayasu

  2. Department of Surgery, Sasebo City General Hospital, Sasebo, Japan

    Soishiro Kiya, Shoto Yamazaki, Masato Araki, Yorihisa Sumida, Takuro Miyazaki, Ryotaro Kamohara, Shigeyuki Morino & Akihiro Nakamura

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Contributions

(I) Conception and design: Shintaro Hashimoto, Tetsuro Tominaga (II) Administrative support: Shintaro Hashimoto, Tetsuro Tominaga, Takuro Miyazaki. (III) Provision of study materials or patients: All authors (IV) Collection and assembly of data: Shintaro Hashimoto, Tetsuro Tominaga, Keisuke Noda, Soishiro Kiya, Toshio Shiraishi, Kaido Oishi, Yuma Takamura, Takashi Nonaka, Masato Araki, Yorihisa Sumida, Takuro Miyazaki, Ryotaro Kamohara, Shigeyuki Morino and Keitaro Matsumoto. (V) Data analysis and interpretation: Shintaro Hashimoto, Tetsuro Tominaga (VI) Manuscript writing: Shintaro Hashimoto, Tetsuro Tominaga. (VII) Final approval of manuscript: All authors.

Corresponding author

Correspondence to Tetsuro Tominaga.

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Supplementary Information

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423_2023_3209_MOESM1_ESM.tif

Supplementary file1 Supplemental Fig. 1. Recurrence-free survival in the number of pulmonary metastases 1 and 2≤ groups. (TIF 163 kb)

423_2023_3209_MOESM2_ESM.tif

Supplementary file2 Supplemental Fig. 2. Overall survival in the number of pulmonary metastases 1 and 2≤ groups. (TIF 158 kb)

423_2023_3209_MOESM3_ESM.tif

Supplementary file3 Supplemental Fig. 3. Recurrence-free survival in the number of pulmonary metastases 2≥ and 3≤ groups. (TIF 160 kb)

423_2023_3209_MOESM4_ESM.tif

Supplementary file4 Supplemental Fig. 4. Overall survival in the number of pulmonary metastases 2≥ and 3≤ groups. (TIF 158 kb)

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Hashimoto, S., Tominaga, T., Nonaka, T. et al. Long-term outcomes and early recurrence after resection for metachronous pulmonary metastases from colorectal cancer. Langenbecks Arch Surg 409, 24 (2024). https://doi.org/10.1007/s00423-023-03209-4

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