Jun Nakajima1, Tomohiko Iida2, Sakae Okumura3, Hirotoshi Horio4, Hisao Asamura5, Yuichi Ozeki6, Norihiko Ikeda7, Haruhisa Matsuguma8, Masayuki Chida9, Hajime Otsuka10, Masafumi Kawamura11. 1. Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan. 2. Department of Thoracic Surgery, Kimitsu Central Hospital, Chiba, Japan. 3. Department of Thoracic Surgical Oncology, Cancer Institute Hospital, Japanese Foundation, Tokyo, Japan. 4. Department of Thoracic Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. 5. Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Keio University, Tokyo, Japan. 6. Department of Thoracic Surgery, National Defense Medical College, Saitama, Japan. 7. Department of Thoracic Surgery, Tokyo Medical University, Tokyo, Japan. 8. Division of Thoracic Surgery, Tochigi Cancer Center, Tochigi, Japan. 9. Department of Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan. 10. Department of Chest Surgery, Toho University Medical Center Omori Hospital, Tokyo, Japan. 11. Division of General Thoracic Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Abstract
OBJECTIVES: New chemotherapeutic regimens (i.e. FOLFOX or FOLFIRI with molecular targeted drugs) have improved the prognosis of patients with unresectable or recurrent colorectal cancer. To estimate the prognostic impact of these chemotherapies, we examined the chronological change in survival rates of patients who underwent pulmonary metastasectomy for colorectal cancer metastasis. METHODS: Using a large database, we conducted a retrospective, multi-institutional study to collect data of 1223 eligible patients from 26 institutions who had undergone pulmonary metastasectomy with curative intent. We divided those patients who underwent metastasectomy in different time periods according to the major trend of chemotherapy regimens for recurrent colorectal cancer: those who underwent metastasectomy between 1990 and 1999 ( N = 451, Group A), between 2000 and 2004 ( N = 433, Group B) or between 2005 and 2007 ( N = 339, Group C). RESULTS: Five-year overall survival rates after metastasectomy were 45% in Group A, 56% in Group B and 66% in Group C ( P < 0.0001) whereas rates after metastasectomy plus chemotherapy were 32% in Group A, 47% in Group B and 70% in Group C ( P = 0.0059). The prognosis of patients who underwent both metastasectomy and chemotherapy in Group C was significantly better than that of the other two groups. Overall survival of patients who did not receive chemotherapy was not significantly different between the groups. CONCLUSION: Survival rates of patients after pulmonary metastasectomy for colorectal cancer metastasis who underwent chemotherapy have increased over the years. It implies that newer chemotherapy regimens might have had a positive impact on these patients.
OBJECTIVES: New chemotherapeutic regimens (i.e. FOLFOX or FOLFIRI with molecular targeted drugs) have improved the prognosis of patients with unresectable or recurrent colorectal cancer. To estimate the prognostic impact of these chemotherapies, we examined the chronological change in survival rates of patients who underwent pulmonary metastasectomy for colorectal cancer metastasis. METHODS: Using a large database, we conducted a retrospective, multi-institutional study to collect data of 1223 eligible patients from 26 institutions who had undergone pulmonary metastasectomy with curative intent. We divided those patients who underwent metastasectomy in different time periods according to the major trend of chemotherapy regimens for recurrent colorectal cancer: those who underwent metastasectomy between 1990 and 1999 ( N = 451, Group A), between 2000 and 2004 ( N = 433, Group B) or between 2005 and 2007 ( N = 339, Group C). RESULTS: Five-year overall survival rates after metastasectomy were 45% in Group A, 56% in Group B and 66% in Group C ( P < 0.0001) whereas rates after metastasectomy plus chemotherapy were 32% in Group A, 47% in Group B and 70% in Group C ( P = 0.0059). The prognosis of patients who underwent both metastasectomy and chemotherapy in Group C was significantly better than that of the other two groups. Overall survival of patients who did not receive chemotherapy was not significantly different between the groups. CONCLUSION: Survival rates of patients after pulmonary metastasectomy for colorectal cancer metastasis who underwent chemotherapy have increased over the years. It implies that newer chemotherapy regimens might have had a positive impact on these patients.
Authors: Michał Pędziwiatr; Magdalena Mizera; Jan Witowski; Piotr Major; Grzegorz Torbicz; Natalia Gajewska; Andrzej Budzyński Journal: Med Oncol Date: 2017-10-30 Impact factor: 3.064