Y Takakura1, Y Miyata, M Okajima, M Okada, Hideki Ohdan. 1. Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. ytaka0621@aol.com
Abstract
OBJECTIVE: Surgical resection has been the first choice of treatment for resectable pulmonary metastases from colorectal cancer. However, early intrapulmonary recurrence is often observed and appropriate assessment of prognostic factors is controversial. The aim of this study was to define the factors affecting survival and intrapulmonary recurrence after surgical treatment of metastatic pulmonary tumours from colorectal cancer. METHOD: A retrospective analysis was performed of 56 consecutive patients who underwent pulmonary resection for colorectal metastases with a focus on prognostic factors and risk factors for intrapulmonary recurrence. RESULTS: The overall 5-year survival rate was 48.2%. In a univariate analysis, a short disease-free interval (DFI), multiple pulmonary metastases and abnormal prethoracotomy carcinoembryonic antigen (CEA) levels were poor prognostic factors. In a multivariate analysis, a short DFI and abnormal prethoracotomy CEA levels were independent prognostic factors. Twenty-two (39.3%) of the 56 patients had recurrences in the remnant lung after resection for pulmonary metastases, and 8 (36.4%) of these 22 patients underwent repeated pulmonary resections. The median DFI between first and second lung metastasis was 13 months. Univariate analyses revealed that multiple and bilateral lung metastases were risk factors for intrapulmonary recurrence. There was also a strong correlation between the DFI for intrapulmonary recurrence after the first pulmonary resection and the DFI for first pulmonary metastases. CONCLUSIONS: A short DFI was a risk factor for early tumour recurrence after resection for pulmonary metastases. The DFI might reflect oncological characteristics such as the tumour doubling time in colorectal cancer.
OBJECTIVE: Surgical resection has been the first choice of treatment for resectable pulmonary metastases from colorectal cancer. However, early intrapulmonary recurrence is often observed and appropriate assessment of prognostic factors is controversial. The aim of this study was to define the factors affecting survival and intrapulmonary recurrence after surgical treatment of metastatic pulmonary tumours from colorectal cancer. METHOD: A retrospective analysis was performed of 56 consecutive patients who underwent pulmonary resection for colorectal metastases with a focus on prognostic factors and risk factors for intrapulmonary recurrence. RESULTS: The overall 5-year survival rate was 48.2%. In a univariate analysis, a short disease-free interval (DFI), multiple pulmonary metastases and abnormal prethoracotomy carcinoembryonic antigen (CEA) levels were poor prognostic factors. In a multivariate analysis, a short DFI and abnormal prethoracotomy CEA levels were independent prognostic factors. Twenty-two (39.3%) of the 56 patients had recurrences in the remnant lung after resection for pulmonary metastases, and 8 (36.4%) of these 22 patients underwent repeated pulmonary resections. The median DFI between first and second lung metastasis was 13 months. Univariate analyses revealed that multiple and bilateral lung metastases were risk factors for intrapulmonary recurrence. There was also a strong correlation between the DFI for intrapulmonary recurrence after the first pulmonary resection and the DFI for first pulmonary metastases. CONCLUSIONS: A short DFI was a risk factor for early tumour recurrence after resection for pulmonary metastases. The DFI might reflect oncological characteristics such as the tumour doubling time in colorectal cancer.
Authors: Michel Gonzalez; John Henri Robert; Nermin Halkic; Gilles Mentha; Arnaud Roth; Thomas Perneger; Hans Beat Ris; Pascal Gervaz Journal: World J Surg Date: 2012-02 Impact factor: 3.352
Authors: V Dell'Acqua; A Surgo; F Kraja; J Kobiela; Maria Alessia Zerella; P Spychalski; S Gandini; C M Francia; D Ciardo; C Fodor; A M Ferrari; G Piperno; F Cattani; S Vigorito; F Pansini; W Petz; R Orecchia; M C Leonardi; B A Jereczek-Fossa Journal: Clin Exp Metastasis Date: 2019-06-04 Impact factor: 5.150