Lung Metastases From Colorectal Cancer: Analysis of Prognostic Factors in a Single Institution Study

Zampino, Maria Giulia; Maisonneuve, Patrick; Ravenda, Paola Simona; Magni, Elena; Casiraghi, Monica; Solli, Piergiorgio; Petrella, Francesco; Gasparri, Roberto; Galetta, Domenico; Borri, Alessandro; Donghi, Stefano; Veronesi, Giulia

doi:10.1016/j.athoracsur.2014.05.048

Cited by 69 publications

(56 citation statements)

References 22 publications

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“…6, 8, and 9 as shown in table 4 ) each had a long DFI (over 20 months) between pancreatic resection and pulmonary recurrence. Several reports have also reported that a longer recurrence-free interval after surgical resection of the primary tumor is an important prognostic factor [22,23,26] . In the case of colorectal cancer, hepatic metastasis is more common in patients with synchronous metastasis, while pulmonary metastasis is more common in those with metachronous metastasis, and the latter group showed a better prognosis [31] .…”

Section: Discussionmentioning

confidence: 99%

Survival Impact of Pulmonary Metastasis as Recurrence of Pancreatic Ductal Adenocarcinoma

et al. 2015

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Aim: This study aimed at investigating the survival impact of pancreatic ductal adenocarcinoma (PDAC) recurrence as pulmonary metastasis. Methods: We performed a retrospective case-control study of 142 patients who underwent curative resection for PDAC at our institution between 2003 and 2012. Clinicopathological features were compared among patients stratified according to the recurrence pattern and pulmonary metastasis treatment strategy. Results: Patients underwent pancreaticoduodenectomy (n = 96), distal (n = 42), or total pancreatectomy (n = 4). At the last follow-up, 99 patients had developed recurrent post-resection PDAC, including 14 cases of isolated pulmonary recurrence. The median overall survival was significantly longer for patients with isolated pulmonary recurrence (40.3 months) than with other metastases (20.9 months; HR 5.85; p = 0.0156). Two patients underwent resection for isolated pulmonary recurrence, and both survived for ∼70 months after primary resection. Conclusion: Patients with first recurrence of PDAC as pulmonary metastasis had a better prognosis than patients with other types of metastases. Moreover, when isolated pulmonary metastasis is controlled for a certain period, pulmonary resection is likely to improve patient survival.

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Section: Discussionmentioning

confidence: 99%

Survival Impact of Pulmonary Metastasis as Recurrence of Pancreatic Ductal Adenocarcinoma

et al. 2015

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“…Tumor size represents the extent of metastatic lung disease because prognostic factors are similar to those included in the classification of primary lung cancer (22). However, the tumor number was not an independent prognostic factor in this study, which was a little bit contrary to a recent report (23). It can be explained that the enrolled indication criteria were different from this report and patient case in this study had a single lesion, but instead had multiple lung metastases.…”

Section: Discussionmentioning

confidence: 49%

Feasibility and Clinical Value of CT-guided¹²⁵I Brachytherapy for Bilateral Lung Recurrences from Colorectal Carcinoma

Wang¹,

Zhang²,

Yang³

et al. 2016

Radiology

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“…In the reports by Gonzalez and Embun, a short DFI was prognostic of decreased survival-rate (10,11). However, in several other studies, DFI did not reach statistical significance (8,9,22). It seems reasonable to speculate that a short DFI would reflect a more aggressive disease or a more advanced primary tumor, which in turn would be detrimental to survival.…”

Section: Discussionmentioning

confidence: 77%

“…In a retrospective study including 199 patients by Zampino et al, overall 5-year survival was reported to be 43%. Fifty-two percent had a CEA of ≤5, and 86% had a DFI of ≥12 months (8). The cut-off for normal vs. elevated CEA level at our hospital was 4 ng/mL, although other studies have used a cut-off level of 5 ng/mL (17)(18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

“…However, the evidence for this practice consists mostly of retrospective trials with variable results (7). Prognostic factors suggested from previous data include disease-free interval (DFI), number and laterality of metastases, hilar and mediastinal lymph nodes (t-LN), previous metastatic disease in the liver, staging of primary tumor, prethoracotomy carcinoembryonic antigen (CEA), K-RAS gene status, carbohydrate antigen 19-9 (CA19-9) and location of the primary tumor (8)(9)(10)(11). However, no consensus has been reached as to what factors should be taken into consideration when recommending surgery or not.…”

Section: Introductionmentioning

confidence: 99%

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Long-term survival after surgery for pulmonary metastases from colorectal cancer: an observational cohort study

et al. 2017

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Background: Evidence for pulmonary metastasectomy following colorectal cancer (CRC) is scarce. The aim of the study was to investigate long-term survival and identify prognostic factors to aid patient selection. Methods: We included all patients who underwent pulmonary resections for CRC metastases between January 01, 2004 and December 31, 2015 in a population-based cohort study. The primary outcome measure was all-cause mortality and was ascertained from Swedish national registers. The Kaplan-Meier estimator was used to calculate cumulative survival. We used Cox regression for estimation of hazard ratios (HR) and 95% confidence intervals (CI) for the association between patient characteristics and survival. During a median follow-up time of 3.2 years, 36% (66/184) patients died. Overall survival at 5 years was 60% (95% CI: 50-68%) and was significantly lower compared to an age-and gender-matched Swedish population. Carcinoembryonic antigen (CEA) level was identified as a prognostic factor for mortality in the age and sex-adjusted analysis (HR, 2.46; 95% CI: 1.15-5.26, P=0.020). Conclusions: We found a steady increase in the number of pulmonary metastasectomies after CRC during the study period. We identified prethoracotomy CEA level as a prognostic factor for long-term survival, which was consistent with prior reports. The 5-year overall survival rate in our study was 60%, which was high in comparison with prior reports. Although our results indicated that current patient selection criteria were reasonable, definitive evidence of efficacy is pending.

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Lung Metastases From Colorectal Cancer: Analysis of Prognostic Factors in a Single Institution Study

Cited by 69 publications

References 22 publications

Survival Impact of Pulmonary Metastasis as Recurrence of Pancreatic Ductal Adenocarcinoma

Survival Impact of Pulmonary Metastasis as Recurrence of Pancreatic Ductal Adenocarcinoma

Feasibility and Clinical Value of CT-guided¹²⁵I Brachytherapy for Bilateral Lung Recurrences from Colorectal Carcinoma

Long-term survival after surgery for pulmonary metastases from colorectal cancer: an observational cohort study

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Lung Metastases From Colorectal Cancer: Analysis of Prognostic Factors in a Single Institution Study

Cited by 69 publications

References 22 publications

Survival Impact of Pulmonary Metastasis as Recurrence of Pancreatic Ductal Adenocarcinoma

Survival Impact of Pulmonary Metastasis as Recurrence of Pancreatic Ductal Adenocarcinoma

Feasibility and Clinical Value of CT-guided125I Brachytherapy for Bilateral Lung Recurrences from Colorectal Carcinoma

Long-term survival after surgery for pulmonary metastases from colorectal cancer: an observational cohort study

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Feasibility and Clinical Value of CT-guided¹²⁵I Brachytherapy for Bilateral Lung Recurrences from Colorectal Carcinoma