Ryu Kanzaki1, Masayoshi Inoue2, Toru Kimura3, Tomohiro Kawamura3, Soichiro Funaki3, Yasushi Shintani3, Masato Minami3, Ichiro Takemasa4, Tsunekazu Mizushima5,6, Masaki Mori5, Meinoshin Okumura3. 1. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-city, Osaka, 565-0871, Japan. rkanzaki@tj8.so-net.ne.jp. 2. Division of Thoracic Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. 3. Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, L5-2-2 Yamadaoka, Suita-city, Osaka, 565-0871, Japan. 4. Department of Surgery, Surgical Oncology and Science, Sapporo Medical University, Sapporo, Japan. 5. Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Japan. 6. Department of Therapeutics for Inflammatory Bowel Diseases, Osaka University Graduate School of Medicine, Suita, Japan.
Abstract
PURPOSE: To clarify the role of pulmonary metastasectomy in colorectal cancer in the era of modern multidisciplinary therapy. METHODS: The characteristics and outcomes of the patients who underwent pulmonary metastasectomy for colorectal cancer through 2002 (n = 26) and from 2003 (n = 68) were compared. RESULTS: The patients treated from 2003 had a smaller tumor size and more frequently had a history of extra-pulmonary relapses than did those treated through 2002. There was a significant improvement in the 5-year overall survival (42.0% vs. 73.1%, p = 0.03) but not the 5-year relapse-free survival (41.4% vs. 37.5%, p = 0.85) after pulmonary metastasectomy from 2003. The rate of patients who received local therapy with curative intent after the first pulmonary metastasectomy was significantly higher in patients treated from 2003 than in those treated through 2002 [4/13, (31%) vs. 25/39 (64%), p = 0.04]. The survival after relapse after the first pulmonary metastasectomy was significantly longer in patients treated from 2003 than in those treated through 2002 (median survival time: 14 vs. 47 months). CONCLUSIONS: Pulmonary metastasectomy for colorectal cancer remains an important treatment option in the sense that it can achieve a good relapse-free survival.
PURPOSE: To clarify the role of pulmonary metastasectomy in colorectal cancer in the era of modern multidisciplinary therapy. METHODS: The characteristics and outcomes of the patients who underwent pulmonary metastasectomy for colorectal cancer through 2002 (n = 26) and from 2003 (n = 68) were compared. RESULTS: The patients treated from 2003 had a smaller tumor size and more frequently had a history of extra-pulmonary relapses than did those treated through 2002. There was a significant improvement in the 5-year overall survival (42.0% vs. 73.1%, p = 0.03) but not the 5-year relapse-free survival (41.4% vs. 37.5%, p = 0.85) after pulmonary metastasectomy from 2003. The rate of patients who received local therapy with curative intent after the first pulmonary metastasectomy was significantly higher in patients treated from 2003 than in those treated through 2002 [4/13, (31%) vs. 25/39 (64%), p = 0.04]. The survival after relapse after the first pulmonary metastasectomy was significantly longer in patients treated from 2003 than in those treated through 2002 (median survival time: 14 vs. 47 months). CONCLUSIONS: Pulmonary metastasectomy for colorectal cancer remains an important treatment option in the sense that it can achieve a good relapse-free survival.
Entities:
Keywords:
Colorectal cancer; Local therapy; Oxaliplatin; Pulmonary metastasis
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