BACKGROUND: Pulmonary resection is the best therapeutic option for lung metastases from colorectal cancer (CRC) today. However, recurrences are frequent following pulmonary resection. We aimed to evaluate the recurrence pattern and treatment of initial pulmonary resection for metastases from CRC. METHODS: Data from 76 patients with recurrence after curative resection of primary CRC and lung metastases were reviewed. The primary outcome measure was overall survival (OS), defined as the interval between the date of recurrence after pulmonary resection and the date of death or last follow-up. Cox regression analyses were performed to identify the factors associated with OS. RESULTS: Recurrence sites after initial pulmonary resection were lung (n = 37), liver (n = 12), others (n = 11), and multiple (n = 16). Treatments for recurrence included surgery (n = 35), chemotherapy (n = 37), and palliative care (n = 4). Of 35 patients who underwent surgery, 22 had pulmonary resection, and 11 had hepatic resection, and 2 had other resection. The 3-year OS was 84.1 % for surgery, 38.9 % for chemotherapy, and 0 % for palliative care, respectively (p < 0.001). In the surgery group, there was no difference in survival between surgical treatments for pulmonary and hepatic recurrences (p = 0.503). Cox regression analyses identified three factors: disease-free interval (DFI) (HR 1.99, 95 % CI 1.03-3.83), surgery (HR 0.30, 95 % CI 0.12-0.72), and recurrence site (lung: HR 0.10, 95 % CI 0.04-0.28, liver: HR 0.08, 95 % CI 0.02-0.31). CONCLUSIONS: The most common recurrence site after resection of lung metastases was the lung. Although the relapse rate is high, surgery for isolated recurrences is a promising strategy, especially for patients with long DFI.
BACKGROUND: Pulmonary resection is the best therapeutic option for lung metastases from colorectal cancer (CRC) today. However, recurrences are frequent following pulmonary resection. We aimed to evaluate the recurrence pattern and treatment of initial pulmonary resection for metastases from CRC. METHODS: Data from 76 patients with recurrence after curative resection of primary CRC and lung metastases were reviewed. The primary outcome measure was overall survival (OS), defined as the interval between the date of recurrence after pulmonary resection and the date of death or last follow-up. Cox regression analyses were performed to identify the factors associated with OS. RESULTS: Recurrence sites after initial pulmonary resection were lung (n = 37), liver (n = 12), others (n = 11), and multiple (n = 16). Treatments for recurrence included surgery (n = 35), chemotherapy (n = 37), and palliative care (n = 4). Of 35 patients who underwent surgery, 22 had pulmonary resection, and 11 had hepatic resection, and 2 had other resection. The 3-year OS was 84.1 % for surgery, 38.9 % for chemotherapy, and 0 % for palliative care, respectively (p < 0.001). In the surgery group, there was no difference in survival between surgical treatments for pulmonary and hepatic recurrences (p = 0.503). Cox regression analyses identified three factors: disease-free interval (DFI) (HR 1.99, 95 % CI 1.03-3.83), surgery (HR 0.30, 95 % CI 0.12-0.72), and recurrence site (lung: HR 0.10, 95 % CI 0.04-0.28, liver: HR 0.08, 95 % CI 0.02-0.31). CONCLUSIONS: The most common recurrence site after resection of lung metastases was the lung. Although the relapse rate is high, surgery for isolated recurrences is a promising strategy, especially for patients with long DFI.
Authors: Henrik Petrowsky; Mithat Gonen; William Jarnagin; Matthias Lorenz; Ronald DeMatteo; Stefan Heinrich; Albrecht Encke; Leslie Blumgart; Yuman Fong Journal: Ann Surg Date: 2002-06 Impact factor: 12.969
Authors: Süleyman Yedibela; Peter Klein; Karsta Feuchter; Martin Hoffmann; Thomas Meyer; Thomas Papadopoulos; Jonas Göhl; Werner Hohenberger Journal: Ann Surg Oncol Date: 2006-09-29 Impact factor: 5.344
Authors: Samer Salah; Kazuhiro Watanabe; Joon Suk Park; Alaa Addasi; Ji Won Park; Jon Zabaleta; Francesco Ardissone; Jhingook Kim; Marc Riquet; Kazunori Nojiri; Mara Gisabella; Sun Young Kim; Kuniya Tanaka Journal: Ann Surg Oncol Date: 2013-01-20 Impact factor: 5.344
Authors: Marc Riquet; Christophe Foucault; Aurélie Cazes; Emmanuel Mitry; Antoine Dujon; Françoise Le Pimpec Barthes; Jacques Médioni; Philippe Rougier Journal: Ann Thorac Surg Date: 2010-02 Impact factor: 4.330