BACKGROUND: The way to select patients who will benefit from surgical resection of pulmonary metastases of colorectal carcinoma (CRC) remains unclear. METHODS: We analyze overall survival and potential prognostic factors in 101 pulmonary resections of CRC metastases in 79 patients, focusing on cases with repeated pulmonary resection or with hepatic metastasectomy. RESULTS: Number of pathological pulmonary metastases was higher than that of preoperatively suspected pulmonary nodules in 18% of the resections. Morbidity rate was 16.5%. There was no mortality. Five-year survival rates from the resection of the CRC and from the first pulmonary metastasectomy were 74.6% and 53.3%, respectively. Prognosis did not decrease in patients with history of hepatic metastasectomy or in those in which repeated pulmonary resection was performed. Age ≥70, preoperative carcinoembrionary antigen (CEA) ≥5 ng/dl and mediastinal lymph node involvement entailed worse prognosis. Pathological lymph node involvement and age were shown as independent prognostic factors in the multivariate analysis. CONCLUSIONS: Resection of pulmonary metastases of CRC is a safe procedure, with 5-year survival rates over 50%. History of resected hepatic metastases or needs for more than one pulmonary resection do not seem to decrease survival rates. Only lymph node involvement and age seem to be clearly associated to worse prognosis.
BACKGROUND: The way to select patients who will benefit from surgical resection of pulmonary metastases of colorectal carcinoma (CRC) remains unclear. METHODS: We analyze overall survival and potential prognostic factors in 101 pulmonary resections of CRC metastases in 79 patients, focusing on cases with repeated pulmonary resection or with hepatic metastasectomy. RESULTS: Number of pathological pulmonary metastases was higher than that of preoperatively suspected pulmonary nodules in 18% of the resections. Morbidity rate was 16.5%. There was no mortality. Five-year survival rates from the resection of the CRC and from the first pulmonary metastasectomy were 74.6% and 53.3%, respectively. Prognosis did not decrease in patients with history of hepatic metastasectomy or in those in which repeated pulmonary resection was performed. Age ≥70, preoperative carcinoembrionary antigen (CEA) ≥5 ng/dl and mediastinal lymph node involvement entailed worse prognosis. Pathological lymph node involvement and age were shown as independent prognostic factors in the multivariate analysis. CONCLUSIONS: Resection of pulmonary metastases of CRC is a safe procedure, with 5-year survival rates over 50%. History of resected hepatic metastases or needs for more than one pulmonary resection do not seem to decrease survival rates. Only lymph node involvement and age seem to be clearly associated to worse prognosis.
Authors: Orlando Jorge Martins Torres; Márcio Carmona Marques; Fabio Nasser Santos; Igor Correia de Farias; Anelisa Kruschewsky Coutinho; Cássio Virgílio Cavalcante de Oliveira; Antonio Nocchi Kalil; Celso Abdon Lopes de Mello; Jaime Arthur Pirola Kruger; Gustavo Dos Santos Fernandes; Claudemiro Quireze; André M Murad; Milton José de Barros E Silva; Charles Edouard Zurstrassen; Helano Carioca Freitas; Marcelo Rocha Cruz; Rui Weschenfelder; Marcelo Moura Linhares; Leonaldson Dos Santos Castro; Charles Vollmer; Elijah Dixon; Héber Salvador de Castro Ribeiro; Felipe José Fernandez Coimbra Journal: Arq Bras Cir Dig Date: 2016 Jul-Sep
Authors: Jon Zabaleta; Borja Aguinagalde; Iker Lopez; Arantza Fernandez-Monge; Jose M Izquierdo; Jose I Emparanza Journal: Cancer Biol Med Date: 2017-08 Impact factor: 4.248