Prognostic impact of lymph node involvement in pulmonary metastases from colorectal cancer

Welter, Stefan; Jacobs, Jan; Krbek, Thomas; Poettgen, C.; Stamatis, Georgios

doi:10.1016/j.ejcts.2006.11.004

Cited by 149 publications

(96 citation statements)

References 25 publications

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“…Several studies have reported the number of pulmonary metastases as a prognostic factor for overall survival 19,23,24,26 , whereas in the present study the number of pulmonary metastases was a significant risk factor for local disease-free survival but not overall survival. Eighteen patients with multiple lung metastases at first resection developed intrapulmonary recurrence, of whom seven underwent repeat pulmonary resection and survived for at least 5 years.…”

Section: Discussioncontrasting

confidence: 75%

“…Repeated thoracotomy for recurrent pulmonary metastases was not a prognostic factor in the present series, as in most previous studies 12,13,23,25 . The 5-year survival rate of patients who had repeated pulmonary resection was 85 per cent in the present study, better than previously published rates of 24·5-54·6 per cent 12,13,23,25 .…”

Section: Discussioncontrasting

confidence: 63%

“…The 5-year survival rate of patients who had repeated pulmonary resection was 85 per cent in the present study, better than previously published rates of 24·5-54·6 per cent 12,13,23,25 . This is possibly because patients were strictly selected by preoperative multimodal assessment, as for the first pulmonary resection.…”

Section: Discussionsupporting

confidence: 45%

See 2 more Smart Citations

Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer

Watanabe

Nagai

Kobayashi

et al. 2009

British Journal of Surgery

141

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Section: Discussioncontrasting

confidence: 75%

Section: Discussioncontrasting

confidence: 63%

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Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer

Watanabe

Nagai

Kobayashi

et al. 2009

British Journal of Surgery

141

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“…The presence of positive intrathoracic lymph nodes resulted in a worse prognosis with a median survival of 64 months for patients without nodal involvement, whereas for patients with hilar and mediastinal nodal disease, median survival was 33 and 21 months, respectively (12). This is supported by several other studies showing a decreased survival when hilar or mediastinal lymph nodes are involved (13)(14)(15)(16). Complete mediastinal nodal dissection prolongs surgical time by a median time of only 15 minutes and does not result in increased morbidity and hospital stay, as shown in a prospective study of the American College of Surgeons Oncology Group (ACOSOG) in patients with early-stage lung cancer undergoing major pulmonary resections (17).…”

Section: Pulmonary and Mediastinal Lymph Node Statussupporting

confidence: 77%

Lung Metastatic Disease: Surgical Resection and Locoregional Chemotherapy

Hengst¹,

Hendriks²,

Schil³

2012

Toraks Cer Bult

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Currently, surgical resection remains the gold standard for resectable lung metastases. Prognostic factors are histology, complete resection, number of metastases and disease-free interval. However, there is a high rate of recurrent disease in the thorax, even if systemic chemotherapy is applied. Because the latter is limited in dose due to systemic toxicity, new treatment options are being developed to selectively deliver high-dose chemotherapy into the lung, reducing systemic toxicity. Isolated lung perfusion (ILuP), similar to isolated limb perfusion, is an experimental surgical technique to deliver highdose chemotherapy into the lung without systemic exposure. Biological response modifiers like tumour necrosis factor can also be administered. ILuP results in significantly higher concentration of chemotherapy in the target organ compared to systemic chemotherapy, together with a survival benefit in experimental models of pulmonary metastases. Several phase I studies have shown that ILuP is technically feasible with low morbidity and low impact on the patient's pulmonary function. However, the utility of this technique is limited because it is an invasive technique. Other techniques to selectively deliver high-dose locoregional chemotherapy are embolic trapping (chemo-embolization), selective pulmonary artery perfusion (SPAP) without control of the venous effluent and the minimally invasive lung suffusion technique. This review will discuss surgical resection of lung metastases and address several techniques developed to deliver high doses of chemotherapy into the lung, as well as the current progress in experimental and clinical studies.

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“…This is likely due to the early detection of metastatic disease with most patients diagnosed with a solitary metastasis <2 cm. Size and number of resected colorectal pulmonary metastases have been previously shown to correlate with outcome [25,26,27,28,29]. The majority of the resected pulmonary cases in our study would have been missed on non-radiographic surveillance given their normal CEA levels.…”

Section: Discussionmentioning

confidence: 70%

Intensive Radiographic and Biomarker Surveillance in Stage II and III Colorectal Cancer

Fora¹,

Patta²,

Attwood³

et al. 2012

Oncology

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Objective: The objective of this study was to determine the rate of salvage resections in patients with stage II and III colorectal cancer following intensive surveillance in a comprehensive cancer center. Methods: Patients with stage II and III colorectal cancer with a minimum follow-up of 3 years were included. Carcinoembryonic antigen was obtained every 3 months for 2 years and then every 6 months for years 3–5. CT scans of the chest, abdomen and pelvis were performed every 6 months for 2 years and then yearly for years 3–5. Colonoscopy was performed at year 1 and then every 3 years. Results: One hundred and seventy-seven patients were followed for a median of 60 months; 44 patients were diagnosed with recurrent disease. CT was the first sign of recurrence in 68% of patients. Carcinoembryonic antigen test was normal in 20 patients (45%) at the time of disease recurrence. Twenty-five patients (57%) with recurrent disease underwent curative-intent resection, 12 of whom are still cancer free at a median follow-up of 81 months. Conclusions: In this retrospective study, intensive radiographic screening was associated with a high salvage resection rate, which led to favorable clinical outcomes. Randomized clinical trials are urgently needed to define the optimal duration and schedule of radiographic screening in stage II and III colorectal cancer.

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Prognostic impact of lymph node involvement in pulmonary metastases from colorectal cancer

Cited by 149 publications

References 25 publications

Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer

Factors influencing survival after complete resection of pulmonary metastases from colorectal cancer

Lung Metastatic Disease: Surgical Resection and Locoregional Chemotherapy

Intensive Radiographic and Biomarker Surveillance in Stage II and III Colorectal Cancer

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