Satoshi Shiono1, Takehiro Okumura2, Narikazu Boku3, Tomoyuki Hishida4, Yasuhisa Ohde5, Yukinori Sakao6, Katsuo Yoshiya7, Ichinosuke Hyodo8, Keita Mori9, Haruhiko Kondo10. 1. Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan. 2. Department of Surgery, School of Medicine, University Hospital Mizonokuchi, Teikyo University, Kanagawa, Japan. 3. Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan. 4. Department of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan. 5. Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan. 6. Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan. 7. Department of Chest Surgery, Niigata Cancer Center Hospital, Niigata, Japan. 8. Division of Gastroenterology Clinical Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan. 9. Clinical Research Support Center, Shizuoka Cancer Center, Shizuoka, Japan. 10. General Thoracic Surgery, School of Medicine, Kyorin University, Tokyo, Japan.
Abstract
Objectives: Although wedge resection is the most common surgical procedure for pulmonary metastases from colorectal cancer, there are few reports about segmentectomy for colorectal metastasectomy. Methods: This was a subset analysis of a Japanese nationwide retrospective study of resected pulmonary metastases from colorectal cancer. The study included 553 patients who underwent segmentectomies ( n = 98) or wedge resections ( n = 455) without preoperative chemotherapy between January 2004 and December 2008. Recurrence patterns, recurrence-free survival and overall survival were analysed for each procedure. Results: As for the patients' background factors, only the median size of resected metastases was different between patients with segmentectomies (median 18 mm, range 5-50 mm) and wedge resections (14 mm, 5-51 mm) ( P < 0.001). Prolonged air leak developed more frequently in those undergoing segmentectomy compared with wedge resection (5.1% vs 1.8%) ( P = 0.048). The resection-margin recurrence rate was higher in patients who underwent wedge resection compared with segmentectomy (7.3% vs 2.0%; P = 0.035). The 5-year recurrence-free survival was 48.8% in patients with segmentectomy and 36.0% in patients with wedge resections. The 5-year overall survival was 80.1% in patients with segmentectomy and 68.5% in patients with wedge resection. Multivariable analysis revealed that the surgical procedure, segmentectomy, was a significant favourable factor for recurrence (hazard ratio: 0.63, 95% confidence interval: 0.44-0.87, P = 0.005), but not for overall survival (hazard ratio: 0.65, 95% confidence interval: 0.38-1.05, P = 0.080). Conclusions: Segmentectomy demonstrated a good efficacy with less resection-margin recurrence in patients with resectable pulmonary-limited metastasis from colorectal cancer.
Objectives: Although wedge resection is the most common surgical procedure for pulmonary metastases from colorectal cancer, there are few reports about segmentectomy for colorectal metastasectomy. Methods: This was a subset analysis of a Japanese nationwide retrospective study of resected pulmonary metastases from colorectal cancer. The study included 553 patients who underwent segmentectomies ( n = 98) or wedge resections ( n = 455) without preoperative chemotherapy between January 2004 and December 2008. Recurrence patterns, recurrence-free survival and overall survival were analysed for each procedure. Results: As for the patients' background factors, only the median size of resected metastases was different between patients with segmentectomies (median 18 mm, range 5-50 mm) and wedge resections (14 mm, 5-51 mm) ( P < 0.001). Prolonged air leak developed more frequently in those undergoing segmentectomy compared with wedge resection (5.1% vs 1.8%) ( P = 0.048). The resection-margin recurrence rate was higher in patients who underwent wedge resection compared with segmentectomy (7.3% vs 2.0%; P = 0.035). The 5-year recurrence-free survival was 48.8% in patients with segmentectomy and 36.0% in patients with wedge resections. The 5-year overall survival was 80.1% in patients with segmentectomy and 68.5% in patients with wedge resection. Multivariable analysis revealed that the surgical procedure, segmentectomy, was a significant favourable factor for recurrence (hazard ratio: 0.63, 95% confidence interval: 0.44-0.87, P = 0.005), but not for overall survival (hazard ratio: 0.65, 95% confidence interval: 0.38-1.05, P = 0.080). Conclusions: Segmentectomy demonstrated a good efficacy with less resection-margin recurrence in patients with resectable pulmonary-limited metastasis from colorectal cancer.
Authors: Federico Davini; Sara Ricciardi; Carmelina C Zirafa; Gaetano Romano; Greta Alì; Gabriella Fontanini; Franca M A Melfi Journal: Int J Colorectal Dis Date: 2019-11-04 Impact factor: 2.571
Authors: Rachel Wong; Jeanne Tie; Margaret Lee; Joshua Cohen; Yuxuan Wang; Lu Li; Stephen Ma; Michael Christie; Suzanne Kosmider; Cristian Tomasetti; Nickolas Papadopoulos; Kenneth W Kinzler; Bert Vogelstein; Peter Gibbs Journal: Int J Cancer Date: 2019-01-24 Impact factor: 7.396