Isolated Pulmonary Recurrence After Resection of Colorectal Hepatic Metastases???Is Resection Indicated?

Labow, Daniel M.; Buell, Joseph E; Yoshida, Atsushi; Rosen, Seth; Posner, Mitchell C.

doi:10.1097/00130404-200207000-00011

Cited by 26 publications

(26 citation statements)

References 24 publications

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“…It has been shown in the literature that early diagnosis of colorectal pulmonary metastases is of paramount importance, as several reports have highlighted the survival benefits of pulmonary metastasectomy. [31][32][33][34] If the metastases could be completely removed, the cumulative 5-and 10-year (total) survival could be as high as 44% and 22%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…These are similar to the criteria mentioned in the literature of suitability for resection of pulmonary metastases. [31][32][33][34] After resection, improved survival was shown to be related to various factors such as smaller number and sizes of metastases, lower intrapulmonary tumor load, long disease-free interval, normal serum CEA level, and the absence of concomitant liver metastases and mediastinal lymph node spread. Pulmonary metastasectomy can even be performed effectively in patients with recurrent disease after prior hepatic resection for colorectal metastases, and prolonged survival can still be achieved.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

How Uncommon are Isolated Lung Metastases in Colorectal Cancer? A Review from Database of 754 Patients Over 4 Years

Tan

Lopes

Sim

2009

Journal of Gastrointestinal Surgery

124

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How Uncommon are Isolated Lung Metastases in Colorectal Cancer? A Review from Database of 754 Patients Over 4 Years

Tan

Lopes

Sim

2009

Journal of Gastrointestinal Surgery

124

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“…However, recently this model has undergone some changes. For example, even more patients presenting pulmonary and liver metastases of colorectal cancer undergo surgery with quite favorable results (5,6,7,8). Surgery of pulmonary metastases should be indicated as a result of consultations of all involved specialists (thoracic surgeon, oncologist, chest physician, anesthesiologist, radiologist) based on individual review of each single case.…”

Section: Discussionmentioning

confidence: 99%

Surgical therapy of pulmonary metastases – 10-year results

Vodička¹,

Spidlen²,

Šimánek³

et al. 2013

BLL

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Introduction:The surgical therapy of selected secondary pulmonary tumors, including both solitary and multiple or bilateral tumours, is currently a generally accepted therapeutic procedure demonstrably extending the long term survival of these patients. Purpose: The purpose of the present study is a ten-year retrospective analysis of a group of patients who underwent surgery due to pulmonary metastases of various primary tumors. Methods: In 2000-2009, 87 patients (of which 44 were male with a median age of 64 years) with secondary pulmonary tumors underwent surgery at the departments of the authors of this study. Solitary metastases were found in 60 patients, multiple metastases in the remaining patients, while 13 patients had bilateral metastases. The median disease-free period from surgery of the primary tumor was 31 months. Results: In total, 74 unilateral and 13 bilateral surgeries were performed in one or two periods. The most common type of surgery included anatomical pulmonary resections (32 procedures), wedge resections (29 procedures) and laser excisions (24 procedures). In total, the radical resection was performed in 156 metastases. Post-operative morbidity was 17.2 % with zero mortality. A proportion of 50.6 % of operated patients survived after resection of metastases with median survival of 39 months. The overall three-year and fi ve-year survivals in the group were 57 % and 38 %, respectively. A proportion of 35.6 % of patients live after resection of metastases without disease progression, and the median is 15 months. Conclusion:The achieved results confi rm the positive role of pulmonary metastasectomy in the therapy of disseminated cancer disease (Tab. 1, Fig. 5, Ref. 34 Hematogeneous pulmonary metastases are generally considered as a sign of advanced generalization of malignant disease. Up to one third of malignant tumors have pulmonary metastases, and in most of them the lungs are even the fi rst site of dissemination. Nevertheless, in a signifi cant number of patients, the pulmonary affl iction is stopped or eliminated during the dissemination of metastases, and these patients may benefi t from radical resection of metastases (1, 2). Surgical therapy of the selected secondary pulmonary tumors, not only solitary but also multiple or bilateral, is today generally the accepted therapeutic procedure which demonstrably extends long term survival of these patients with acceptable peri-operative morbidity and mortality. The purpose of the following study is a retrospective analysis of a group of patients who underwent surgery due to pulmonary metastases of various primary tumors over a period of ten years. Material and methodsIn 2000-2009 we performed surgery on 87 patients with secondary pulmonary tumors. Only patients who had undergone a radical resection of the primary tumor, were free from other extrapulmonary metastases, their pulmonary metastases appeared to be radically removable according to the pre-operative examinations as for the number and location, and the benefi t of surgery...

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“…A majority of patients who underwent both hepatic and pulmonary resections for metastatic colorectal cancer receive adjuvant therapy. 61,67,[72][73][74] Multiple attempts have been made to refine patient selection by identification of prognostic indicators. These analyses are limited by the small numbers of patients available for analysis.…”

Section: Colorectal Metastases In the Liver And Lungmentioning

confidence: 99%

Detection and Management of Extrahepatic Colorectal Cancer in Patients with Resectable Liver Metastases

Yang¹,

Fleshman

Strasberg

2007

Journal of Gastrointestinal Surgery

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The presence of extrahepatic disease has a great effect on the management of patients with metastatic colorectal cancer in the liver. FDG-PET scanning is currently the most sensitive way of detecting extrahepatic metastases in such patients. This is supported by 10 studies, which show that FDG-PET scan will discover extrahepatic disease in about one in six patients who have completed standard imaging. Staging laparoscopy is another means of detecting extrahepatic disease. Its role remains undefined especially in patients who have had FDG-PET scans. It should probably be restricted to patients with high clinical risk scores. In terms of treatment, patients with recurrence at the primary colorectal site as well as resectable liver metastases appear to benefit from resection of both sites provided that R0 resections can be obtained. Resection of involved hepatic pedicle lymph nodes in patients with resectable liver metastases is associated with poor outcome. The situation regarding patients with peritoneal and liver metastases bears a strong resemblance to that of primary site recurrence and liver metastases. Very acceptable survival can be expected if the peritoneal disease can be eradicated. Information regarding treatment of lung and liver metastases is the most complete of any of these areas. Good results may be expected if all the disease can be cleared. Caution is required in interpreting claims of good survival when study numbers are small and confidence intervals of data are not provided.

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Isolated Pulmonary Recurrence After Resection of Colorectal Hepatic Metastases???Is Resection Indicated?

Cited by 26 publications

References 24 publications

How Uncommon are Isolated Lung Metastases in Colorectal Cancer? A Review from Database of 754 Patients Over 4 Years

How Uncommon are Isolated Lung Metastases in Colorectal Cancer? A Review from Database of 754 Patients Over 4 Years

Surgical therapy of pulmonary metastases – 10-year results

Detection and Management of Extrahepatic Colorectal Cancer in Patients with Resectable Liver Metastases

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