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Survival after Lung Metastasectomy in Colorectal Cancer Patients with Previously Resected Liver Metastases

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Abstract

Background

Resection of hepatic metastases is indicated in selected stage IV colorectal cancer (CRC) patients. A minority will eventually develop pulmonary metastases and may undergo lung surgery with curative intent. The aims of the present study were to assess clinical outcome and identify parameters predicting survival after pulmonary metastasectomy in patients who underwent prior resection of hepatic CRC metastases.

Methods

We performed a retrospective analysis of 27 consecutive patients (median age 62 years; range: 33–75 years) who underwent resection of pulmonary metastases after previous hepatic metastasectomy from CRC in two institutions from 1996 to 2009. All patients underwent complete resection (R0) for both colorectal and hepatic metastases.

Results

Median follow-up was 32 months (range: 3–69 months) after resection of lung metastases and 65 months (range: 19–146 months) after resection of primary CRC. Three- and 5-year overall survival rates after lung surgery were 56 and 39%, respectively, and median survival was 46 months (95% CI 35–57). Median disease-free survival after pulmonary metastasectomy was 13 months (95% CI 5–21). At the time of last follow-up, seven patients (26%) had no evidence of recurrent disease and 6 of these 7 patients presented initially with a single lung metastasis.

Conclusions

Resection of lung metastases from CRC patients may result in prolonged survival, even after previous hepatic metastasectomy. Yet, prolonged disease-free survival remains the exception, and seems to occur only in patients with a single lung lesion.

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Authors and Affiliations

  1. Department of Thoracic Surgery, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Michel Gonzalez & Hans Beat Ris

  2. Department of Visceral Surgery, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 46, 1011, Lausanne, Switzerland

    Nermin Halkic

  3. Department of Thoracic Surgery, Geneva University Hospital, Geneva, Switzerland

    John Henri Robert

  4. Department of Visceral Surgery, Geneva University Hospital, Geneva, Switzerland

    Gilles Mentha & Pascal Gervaz

  5. Department of Oncology, Geneva University Hospital, Geneva, Switzerland

    Arnaud Roth

  6. Department of Biostatistics, Geneva University Hospital, Geneva, Switzerland

    Thomas Perneger

Authors
  1. Michel Gonzalez
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  2. John Henri Robert
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  3. Nermin Halkic
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  4. Gilles Mentha
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  5. Arnaud Roth
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  6. Thomas Perneger
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  7. Hans Beat Ris
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  8. Pascal Gervaz
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Correspondence to Michel Gonzalez.

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Gonzalez, M., Robert, J.H., Halkic, N. et al. Survival after Lung Metastasectomy in Colorectal Cancer Patients with Previously Resected Liver Metastases. World J Surg 36, 386–391 (2012). https://doi.org/10.1007/s00268-011-1381-3

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  • DOI: https://doi.org/10.1007/s00268-011-1381-3

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