Epidemiology, management and prognosis of colorectal cancer with lung metastases: a 30-year population-based study

Mitry, Emmanuel; Guiu, Boris; Cosconea, Simona; Jooste, Valérie; Faivre, Jean; Bouvier, Anne–Marie

doi:10.1136/gut.2010.211557

Cited by 308 publications

(226 citation statements)

References 23 publications

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“…Mitry et al (11) analysed lung metastases in CRC patients via a 30-year population study. They observed higher risk for lung metastases in rectal tumours than in colon tumours and suggested that rectal carcinoma patients should be submitted to the most specific screening tests to identify lung metastases.…”

Section: Discussionmentioning

confidence: 99%

Carcinoembryonic Antigen Levels in the Peripheral and Mesenteric Venous Blood of Patients With Rectal Carcinoma

Rezende

Palma

Toloi

et al. 2013

Arq. Gastroenterol.

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ContextThe serum carcinoembryonic antigen (CEA) is an important prognostic factor in colorectal cancer, however the rectum presents different routes of venous drainage, stating that the level of CEA in peripheral and mesenteric rectal tumors may be different, depending on the location of the tumor in the rectal segment.ObjectiveThe goal of this study was to evaluate the relationship between the peripheral and mesenteric venous levels of CEA and the association between these levels and the tumour location in the rectums of patients successfully operated on for rectal carcinoma.MethodsThirty-two patients who were surgically treated for rectal carcinoma were divided into patients with tumours located in the upper rectum (n = 11) or lower rectum (n = 21). The CEA values were assessed by electrochemiluminescence immunoassay. Serum and mesenteric CEA levels were associated with the tumour anatomopathological characteristics: location, histological type, cellular differentiation grade, depth of invasion into the rectal wall, angiolymphatic invasion, tumour, node, and metastasis staging; and the CEA index (≤1.0 or ≥1.0 ng /mL).ResultsAnalysis of the serum CEA values using clinical and anatomopathological parameters revealed no significant association with tumour location, histological type, cellular differentiation grade, depth of invasion into the intestinal wall, and tumour, node, and metastasis staging. The mesenteric CEA levels were significantly associated with the tumour location (P = 0.01). The CEA values in the mesenteric venous blood and the presence of angiolymphatic invasion (P = 0.047) were significantly different. A significant relationship was found between the CEA index value and the rectal tumour location (P = 0.0001).ConclusionsThe CEA levels were higher in the mesenteric vein in tumours located in the upper rectum and in the presence of angiolymphatic invasion. CEA drainage from lower rectum adenocarcinomas preferentially occurs through the systemic pathway.

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Section: Discussionmentioning

confidence: 99%

Carcinoembryonic Antigen Levels in the Peripheral and Mesenteric Venous Blood of Patients With Rectal Carcinoma

Rezende

Palma

Toloi

et al. 2013

Arq. Gastroenterol.

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“…In einer Kohortenstudie aus Frankreich traten bei 5,8 % der Patienten innerhalb von 5 Jahren nach kurativer Resektion eines kolorektalen Karzinoms im Verlauf Lungenmetastasen auf [1276]. Die Rate an Lungenmetastasen nach 1 Jahr betrug 0,9 %, nach 3 Jahren 4,2 %.…”

Section: Hintergrundunclassified

S3-Leitlinie – Kolorektales Karzinom

Schmiegel

Buchberger

Follmann³

et al. 2017

Z Gastroenterol

133

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“…Around 10-20% of patients with CRC developed p u l m o n a r y m e t a s t a s e s ( 2 ) . A l t h o u g h p u l m o n a r y metastasectomy could be a radical choice for rigorously selected patients (3), a certain quantity of subjects with PM are managed with palliative intent and have a poor outcome.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary metastasectomy for colorectal cancer: analysis of prognostic factors affecting survival

et al. 2017

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Background: Pulmonary metastasectomy is considered a standard procedure in the treatment of metastatic colorectal cancer (CRC). Different prognostic factors including multiple metastatic nodules, the presence of extra-pulmonary metastases and BRAF mutation status have been associated with poor survival. The aim of this study was to evaluate which factors influenced survival in CRC patients undergoing pulmonary metastasectomy by studying primary tumors and pulmonary metastases. Methods: All patients treated for primary CRC who presented pulmonary metastases in a 10-year period were considered (group A). A control group treated for primary CRC who did not develop any pulmonary or extra-pulmonary metastases was taken for comparison (group B). Different prognostic factors including gender, age, tumor location, histological type, inflammatory infiltrate, BRAF, CDX2 and extra-pulmonary metastases were analyzed. Overall survival (OS) and patients' survival after pulmonary metastasectomy were also considered. Results: Fifty-four patients were evaluated in group A and twenty-three in group B. In group A, BRAF immunohistochemistry did not significantly differ between primary tumors and pulmonary metastases; no difference of BRAF expression was found between group A and B. Even the expression of CDX2 was not significantly different in primary tumors and metastases. Similarly, in group B CDX2 did not significantly differ from primary CRC of group A. The most significant prognostic factor was the presence of extra-pulmonary metastases. Patients with extra-pulmonary metastases experienced a significant shorter survival compared to patients with pulmonary metastases alone (P=0.001 with log-rank test vs. P=0.003 with univariate Cox regression). Interestingly, patients with right pulmonary metastases presented a significant longer survival than those with left pulmonary metastases (P=0.027 with log-rank test vs. 0.04 with univariate Cox regression). Conclusions: The main prognostic factor associated with poor survival after lung resection of CRC metastases is a history of extra-pulmonary metastases. BRAF and CDX2 did not have a significant role in this small series of patients.

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Epidemiology, management and prognosis of colorectal cancer with lung metastases: a 30-year population-based study

Cited by 308 publications

References 23 publications

Carcinoembryonic Antigen Levels in the Peripheral and Mesenteric Venous Blood of Patients With Rectal Carcinoma

Carcinoembryonic Antigen Levels in the Peripheral and Mesenteric Venous Blood of Patients With Rectal Carcinoma

S3-Leitlinie – Kolorektales Karzinom

Pulmonary metastasectomy for colorectal cancer: analysis of prognostic factors affecting survival

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