Pulmonary metastasectomy for colorectal cancer: How many nodules, how many times?

Kim, Hong Kwan; Cho, Jong Ho; Lee, Ho Yun; Lee, Jeeyun; Kim, Jhingook

doi:10.3748/wjg.v20.i20.6133

Cited by 67 publications

(62 citation statements)

References 110 publications

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“…Previous studies including our series show the prognostic significance of hilar and/or mediastinal lymph node involvement (4,7,(9)(10)(11). Even if the role of mediastinal systematic nodal dissection remains unclear (12), our results and the bulk of previous literature supported the lymph node sampling practice.…”

Section: Discussionsupporting

confidence: 76%

“…In case of local relapses after lung metastasectomy, redo-surgery could be a reasonable therapeutic choice: in the last years, a number of reports in the literature documented a survival benefit after re-resection (7,10). In our experience, 5-year survival of patient submitted to repeat lung metastasectomy is encouraging (49%).…”

Section: Discussionsupporting

confidence: 51%

“…In our institution, multiple resection of colorectal MTS is usually achieved when feasible: the results presented in this study indicated a similar survival from 1 to 4 resected metastases. In the recent years, some studies have documented a comparable comforting survival in oligometastatic patients (9)(10)(11)20,21), probably resulting from improvements in pre-operative selection, surgical techniques and perioperative management. Although this finding deserves future validation, the significant prognostic value of the presence of more than five metastases corroborates the importance of surgery in oligometastatic disease.…”

Section: Discussionmentioning

confidence: 99%

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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%

Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

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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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“…While primary cancers are under improved control by multimodal therapy, the development of metastases is considered the most important factor for the patient's survival. If untreated, patients suffering from colorectal lung metastases have a median of 10 months survival [3].…”

Section: Introductionmentioning

confidence: 99%

Suppression of lung metastases by the CD26/DPP4 inhibitor Vildagliptin in mice

Jang

Baerts

Waumans

et al. 2015

Clin Exp Metastasis

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Metastases rather than primary cancers determine nowadays the survival of patients. One of the most common primary malignancies is colorectal cancer and this type of tumor is characterized by a high tendency to spread metastases to the lung and liver. CD26/DPP4 is a transmembrane molecule with enzymatic functions which cleaves biologically active peptides. Recently, CD26/DPP4 has become the focus of cancer research and it was shown that CD26/DPP4-positive cancer cells display increased metastatic activity. Here, we tested if the CD26/DPP4-inhibitor Vildagliptin suppresses the development and growth of mouse colorectal lung metastases. This inhibitor of CD26/DPP4 was employed on mouse (C57BL/6) colorectal lung metastases, established by intravenous injection of the syngeneic cell line MC38. For mechanistic analysis, a subcutaneous tumor model was used. The treatment with Vildagliptin significantly suppressed both, the incidence and growth of lung metastases. Autophagy markers (LC3, p62, and ATF4) decreased, apoptosis increased (TUNEL, pH3/Ki-76), and the cell cycle regulator pCDC2 was inhibited. In conclusion, we here showed an anti-tumor effect of Vildagliptin via downregulation of autophagy resulting in increased apoptosis and modulation of the cell cycle. We therefore propose Vildagliptin for the evaluation as a new therapeutic approach for the treatment of colorectal cancer lung metastases.

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“…Etwa 30% entwickeln Lebermetastasen [2], und bei ungefähr 20% kommt es zu Lungenmetastasen [3,4], die beiden häufigsten Lokalisationen für Fernmetastasen. Das Auftreten von Metastasen in der Lunge ist mit einer besseren Prognose verbunden als in anderen Körperregionen, und die Krankheitsprogression verläuft langsamer [5]. Therapie der ersten Wahl ist die Resektion mit einer möglichen adjuvanten stereotaktischen Körperbestrah-lung (stereotactic body radiation therapy, SBRT) oder thermoablativen Prozeduren als Salvage-Verfahren.…”

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Mikrowellenablation und Immunaktivierung in der Behandlung rezidivierender Lungenmetastasen eines Kolorektalkarzinoms: Ein Fallbericht

Bäcklund

Freedman

2017

Kompass Pneumol

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Wir berichten über eine Patientin mit Metastasen eines Kolorektalkarzinoms, die auf die Lunge begrenzt waren und mehrfach reseziert wurden, bis die Resektion keine therapeutische Option mehr darstellte; daraufhin wurde eine stereotaktische Körperbestrahlung durchgeführt bis auch diese Option ausgeschöpft war. Anschließend erfolgte eine erfolgreiche Behandlung mit multiplen Mikrowellenablationen in Kombination mit einer immunaktivierenden Therapie, die am programmed cell death 1 receptor (PD-1) angreift und möglicherweise einen starken abscopalen Effekt auslöst. Im Folgenden werden Verfahren, Dosierungen und radiologische Befunde dargestellt. Übersetzung aus Case Rep Oncol 2017;10:383-387 (DOI: 10.1159/000468982)

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Pulmonary metastasectomy for colorectal cancer: How many nodules, how many times?

Cited by 67 publications

References 110 publications

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

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

Suppression of lung metastases by the CD26/DPP4 inhibitor Vildagliptin in mice

Mikrowellenablation und Immunaktivierung in der Behandlung rezidivierender Lungenmetastasen eines Kolorektalkarzinoms: Ein Fallbericht

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