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Prognostic Factors of Pulmonary Metastasectomy for Colorectal Carcinomas

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Abstract

Background

Pulmonary metastasectomy for colorectal carcinoma is a well-accepted procedure; however, reports on indications and prognostic factors are inconsistent. This study was designed to clarify a role for resection of pulmonary metastases for such tumors and to define the patients who benefit from pulmonary metastasectomy.

Methods

Between 1990 and 2007, 84 patients with pulmonary metastases from colorectal carcinomas underwent curative pulmonary resection. All patients had obtained or had obtainable locoregional control of their primary tumors. Various perioperative variables were investigated retrospectively to confirm a role for metastasectomy and to analyze prognostic factors for overall survival and disease-free survival after metastasectomy.

Results

Overall survival rate after metastasectomy was 60.5% and 48.4% at 5 and 10 years, respectively. Disease-free survival rate was 34.4% and 30.6% at 5 and 10 years after pulmonary resection, respectively. On multivariate analysis, patients with unilateral pulmonary metastasis presented a significantly favorable overall survival (= 0.045). In contrast, there was no significant prognostic factor for disease-free survival.

Conclusions

Current practice of pulmonary metastasectomy for colorectal carcinoma in our institution was well justified. Our study confirmed that unilateral pulmonary metastasis was significantly relevant to a better prognosis.

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References

  1. McCormack PM, Burt ME, Bains MS et al (1992) Lung resection for colorectal metastases. 10-year results. Arch Surg 127:1403–1406

    PubMed  CAS  Google Scholar 

  2. Goya T, Miyazawa N, Kondo H et al (1989) Surgical resection of pulmonary metastases from colorectal cancer. 10-year follow-up. Cancer 64:1418–1421

    Article  PubMed  CAS  Google Scholar 

  3. August DA, Ottow RT, Sugerbaker PH (1984) Clinical prospective of human colorectal cancer metastasis. Cancer Metastasis Rev 3:303–324

    Article  PubMed  CAS  Google Scholar 

  4. Simmonds PC (2000) Palliative chemotherapy for advanced colorectal cancer: systemic review and meta-analysis. Colorectal Cancer Collaborative Group. BMJ 321:531–535

    Article  PubMed  CAS  Google Scholar 

  5. Semour MT, Stenning SP, Cassidy J (1997) Attitudes and practice in the management of metastatic colorectal cancer in Britain. Colorectal Cancer Working Party of the UK Medical Research Counsil. Clin Oncol (R Coll Radiol) 9:248–251

  6. Treasure T (2008) Pulmonary metastasectomy for colorectal cancer: weak evidence and no randomised trials. Eur J Cardiothorac Surg 33:300–302

    Article  PubMed  Google Scholar 

  7. McCormack P (1990) Surgical resection of pulmonary metastases. Sem Surg Oncol 6:297–302

    Article  CAS  Google Scholar 

  8. Patel AN, Lamb J, Patel N et al (2003) Clinical trials for pulmonary metastasectomy. Semin Thorac Cardiovasc Surg 15:457–463

    Google Scholar 

  9. Pastorino U (2002) History of the surgical management of pulmonary metastases and development of the international registry. Semin Thorac Cardiovasc Surg 14:18–28

    Article  PubMed  Google Scholar 

  10. Sternberg DI, Sonett JR (2007) Surgical therapy of lung metastases. Semin Oncol 34:186–196

    Article  PubMed  Google Scholar 

  11. Higashiyama M, Kodama K, Higaki N et al (2003) Surgery for pulmonary metastases from colorectal cancer: the importance of prethoracotomy serum carcinoembryonic antigen as an indicator of prognosis. Jpn J Thorac Cardiovasc Surg 51:289–296

    Article  PubMed  Google Scholar 

  12. Lee WS, Yun SH, Chun HK et al (2007) Pulmonary resection for metastases from colorectal cancer: prognostic factors and survival. Int J Colorectal Dis 22:699–704

    Article  PubMed  Google Scholar 

  13. Pfannschmidt J, Muley T, Hoffmann H et al (2003) Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experiences in 167 patients. J Thorac Cardiovasc Surg 126:732–739

    Article  PubMed  Google Scholar 

  14. Rena O, Casaido C, Viano F et al (2002) Pulmonary resection for metastases from colorectal cancers: factors influencing prognosis. Twenty-year experience. Eur J Cardiothoracic Surg 21:906–912

    Article  Google Scholar 

  15. Saito Y, Omiya H, Kohno K et al (2002) Pulmonary metastasectomy for 165 patients with colorectal carcinoma: a prognostic assessment. J Thorac Cardiovasc Surg 124:1007–1013

    Article  PubMed  Google Scholar 

  16. Sakamoto T, Tsubota N, Iwanaga K et al (2001) Pulmonary resection for metastases from colorectal cancer. Chest 119:1069–1072

    Article  PubMed  CAS  Google Scholar 

  17. Shiono S, Ishii G, Nagai K et al (2005) Histopathologic prognostic factors in resected colorectal lung metastases. Ann Thorac Surg 79:278–283

    Article  PubMed  Google Scholar 

  18. Melloni G, Doglioni C, Bandiera A et al (2006) Prognostic factors and analysis of microsatellite instability in resected pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 81:2008–2013

    Article  PubMed  Google Scholar 

  19. Watanabe I, Arai T, Ono M et al (2003) Prognostic factors in resection of pulmonary metastasis from colorectal cancer. Br J Surg 90:1436–1440

    Article  PubMed  CAS  Google Scholar 

  20. Inoue M, Ohta M, Iuchi K et al (2004) Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma. Ann Thorac Surg 78:238–244

    Article  PubMed  Google Scholar 

  21. Pihl E, Hughes ES, McDermott FT et al (1987) Lung recurrence after curative surgery for colorectal cancer. Dis Colon Rectum 30:417–419

    Article  PubMed  CAS  Google Scholar 

  22. Pastorino U, Buyse M, Friedel G et al (1997) Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases. The International Registry of Lung Metastases. J Thorac Cardiovasc Surg 113:37–49

    Google Scholar 

  23. Rusch VW (1995) Pulmonary metastasectomy: current indications. Chest 107(6 Suppl):322S–331S

    Article  PubMed  CAS  Google Scholar 

  24. Pfannschmidt J, Dienemann H, Hoffmann H (2007) Surgical resection of pulmonary metastases from colorectal cancer: a systemic review of published series. Ann Thorac Surg 84:324–338

    Article  PubMed  Google Scholar 

  25. Nakajima J, Murakawa T, Fukami T, Takamoto S (2008) Is thoracoscopic surgery justified to treat pulmonary metastasis from colorectal cancer? Interact Cardiovasc Thorac Surg 7:212–217

    Article  PubMed  Google Scholar 

  26. Warwick R, Page R (2007) Resection of pulmonary metastases from colorectal carcinoma. Eur J Surg Oncol 33:S59–S63

    PubMed  Google Scholar 

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Correspondence to Hiroshi Date.

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Chen, F., Hanaoka, N., Sato, K. et al. Prognostic Factors of Pulmonary Metastasectomy for Colorectal Carcinomas. World J Surg 33, 505–511 (2009). https://doi.org/10.1007/s00268-008-9875-3

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