Benefits of surgery for patients with pulmonary metastases from colorectal carcinoma

Inoue, Masayoshi; Ohta, Mitsunori; Iuchi, Keiji; Matsumura, Akira; Ideguchi, Kan; Yasumitsu, Tsutomu; Nakagawa, Katsuhiro; Fukuhara, Kenjiro; Maeda, Hitoshi; Takeda, Shin‐ichi; Minami, Masato; Ohno, Yuko; Matsuda, Hikaru

doi:10.1016/j.athoracsur.2004.02.017

Cited by 256 publications

(171 citation statements)

References 31 publications

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“…In the present study as well as previously reported in literature (15,16), pathologic stage of primary CRC had a significant impact on survival. Nonetheless, there is no definite agreement on the value of its prognostic role: the majority of authors failed to confirm a correlation between primary tumor stage and survival (4,17).…”

Section: Discussionsupporting

confidence: 76%

Surgery of colorectal cancer lung metastases: analysis of survival, recurrence and re-surgery

Guerrera¹,

Mossetti²,

Ceccarelli³

et al. 2016

J. Thorac. Dis.

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Background: Surgery is considered an effective therapeutic option for patients with lung metastasis (MTS) of colorectal cancer (CRC). The purpose of the study was to evaluate efficacy and feasibility of lung metastasectomy in CRC patients and to explore factors of prognostic relevance. Methods: This is a retrospective study of patients operated for lung MTS of CRC from 2004 to 2012 in a single Institution. Overall survival (OS) was the primary endpoint. Secondary endpoints were progression free survival (PFS) in resection status R0 and OS in in patients submitted to re-resections. In order to evaluate prognostic factors, a multivariable Cox proportional hazard model was performed.Results: One-hundred eighty-eight consecutive patients were included in the final analysis. The median follow-up (FU) was 45 months. The 5-year OS and PFS were 53% (95% CI: 44-60%) and 33% (95% CI: 25-42%), respectively. Two-and 5-year survival after re-resection were 79% (95% CI: 63-89%) and 49% (95% CI: 31-65%), respectively. Multivariate adjusted analysis showed that primary CRC pathological TNM stages (P=0.019), number of resected MTS ≥5 (P=0.009) and lymph nodal involvement (P<0.0001) are independent predictors of poor prognosis. Conclusions: Patients operated and re-operated for lung MTS from CRC cancers showed encouraging survival rates. Our results indicated that primary CRC stage, number of MTS and lymph nodal involvement are strong predictive factors. Prognosis after surgery remained comforting up to four resected MTS. Adjuvant chemotherapy seems to have a benefit on survival in patients affected by multiple metastases.Finally, according to the high rate of unidentified lymph node involvement in pre-operative setting, lymph node sampling should be advisable for a correct staging. randomized trial and the undefined role of metastasectomy remained the unsolved problem in the management of patients with pulmonary metastasis (MTS) of CRC (5).The purpose of the study was to evaluate the efficacy and the feasibility of lung metastasectomy in colorectal cancer (CRC) in our institution. Moreover, we aimed at exploring prognostic factors for survival and evaluating survival pattern in patients submitted to re-resections. MethodsWe included all consecutive patients who underwent lung metastectomy for pulmonary metastases from CRC at Department of Thoracic Surgery, University of Torino, Italy-from 2004 to 2012. Data were retrospective collected from the surgical registry of our Department. Follow-up (FU) data were acquired by routine visits, telephone contacts or from administrative data (outpatient regional registry). FU was completed over July 2014. Our Institutional Review Board approved the study. Inclusion criteria for lung metastasectomy comprised locally controlled primary CRC, no evidence of extra-thoracic lesions excluding hepatic metastases, single or multiple pulmonary nodules suitable for a radical resection. Stage of primary CRC was assigned according to the Union Internationale Contre le Cancer (UICC) staging system. Pre-op...

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Section: Discussionsupporting

confidence: 76%

Surgery of colorectal cancer lung metastases: analysis of survival, recurrence and re-surgery

Guerrera¹,

Mossetti²,

Ceccarelli³

et al. 2016

J. Thorac. Dis.

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“…Surgical resection is the most frequently used method and is by most regarded the standard Resection of extra-hepatic CRC-metastases has also been shown to be beneficial. In a study of patients with extra-hepatic CRC-metastases of miscellaneous localizations, 32% of the patients survived after 5 years [3] and in a study of CRC-lung metastases, 45% of the patients survived 5 years after resection [4]. Even though these retrospective studies represent highly selected patients and that a large proportion of patient have received systemic treatments that affect the survival, these results are superior to what should be expected in patients with metastatic CRC [10].…”

Section: Discussionmentioning

confidence: 56%

“…Long term results from retrospective analysis of patients treated with resection of CRC liver metastases show 5-year overall survival rates of approximately 30% [1,2]. Also patients with CRC lung metastases may benefit from surgical resection of metastases [3,4]. Even though it is possible to perform extensive resection of the liver and the lung with removal of as much as 80% or 50% of the organs, respectively, the percentage of patients that are amendable for surgery is most often only in the range of 10 Á25%.…”

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confidence: 99%

Phase II study on stereotactic body radiotherapy of colorectal metastases

et al. 2006

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“…These findings are consistent with many studies in medical literature, demonstrating that metastasectomy improves survival. These studies reported that liver and lung metastasectomy in CRC cases significantly improved survival (Tournigand et al, 2004;Inoue et al, 2004;Cokmert et al, 2014). Additionally, the higher number of patients who had undergone metastasis surgery in the adjuvant group may be due to the fact that these patients were followed-up and that their metastases had been detected in early stages.…”

Section: Discussionmentioning

confidence: 99%