P Girard1, P Baldeyrou, D Grunenwald. 1. Service de Chirurgie thoracique, Institut mutualiste Montsouris, Centre médico-chirurgical de la Porte de Choisy, Paris.
Abstract
OBJECTIVES: Surgery has become a recognized therapeutic means in selected patients with isolated pulmonary metastases, with a 5-year survival rate of about 35%, but specific studies on the results and prognosis of surgery for pulmonary metastases from colorectal cancer remain relatively rare. METHODS: Between 1980 and 1991, 65 patients (34 men, 31 women, mean age 58.2 years) underwent 81 thoracic operations with curative intent (including 15 bilateral operations and 7 incomplete resections) for pulmonary metastases from colorectal cancer. RESULTS: The 5- and 10-year probabilities of survival (Kaplan-Meier) after the first thoracic operation were 27% and 22% respectively. The site of the primary tumor (colon or rectum), the disease-free interval, previous resection(s) of hepatic metastases, and the size of pulmonary metastases were not found to the have a statistically significant influence on prognosis. On the other hand, the quality of resection (complete or incomplete) (p < 0.001), the number of resected pulmonary metastases (p = 0.016), and the preoperative carcino-embryonic antigen level (p < 0.001) were found to be highly significant prognostic factors. CONCLUSION: Complete resection of pulmonary metastases from colorectal cancer seems to prolong survival in a significant number of patients, and the results from this study should help to select those who may benefit from this treatment.
OBJECTIVES: Surgery has become a recognized therapeutic means in selected patients with isolated pulmonary metastases, with a 5-year survival rate of about 35%, but specific studies on the results and prognosis of surgery for pulmonary metastases from colorectal cancer remain relatively rare. METHODS: Between 1980 and 1991, 65 patients (34 men, 31 women, mean age 58.2 years) underwent 81 thoracic operations with curative intent (including 15 bilateral operations and 7 incomplete resections) for pulmonary metastases from colorectal cancer. RESULTS: The 5- and 10-year probabilities of survival (Kaplan-Meier) after the first thoracic operation were 27% and 22% respectively. The site of the primary tumor (colon or rectum), the disease-free interval, previous resection(s) of hepatic metastases, and the size of pulmonary metastases were not found to the have a statistically significant influence on prognosis. On the other hand, the quality of resection (complete or incomplete) (p < 0.001), the number of resected pulmonary metastases (p = 0.016), and the preoperative carcino-embryonic antigen level (p < 0.001) were found to be highly significant prognostic factors. CONCLUSION: Complete resection of pulmonary metastases from colorectal cancer seems to prolong survival in a significant number of patients, and the results from this study should help to select those who may benefit from this treatment.
Authors: Ann Z Bauer; Shanna H Swan; David Kriebel; Zeyan Liew; Hugh S Taylor; Carl-Gustaf Bornehag; Anderson M Andrade; Jørn Olsen; Rigmor H Jensen; Rod T Mitchell; Niels E Skakkebaek; Bernard Jégou; David M Kristensen Journal: Nat Rev Endocrinol Date: 2021-09-23 Impact factor: 43.330