Post-pulmonary metastasectomy prognosis after curative resection for colorectal cancer.

Abstract

PURPOSE:

We aimed to compare disease-free survival after pulmonary metastasectomy to that after hepatic metastasectomy, and to identify prognostic factors after pulmonary metastasectomy.

RESULTS:

Between 2005 and 2015, 129 patients underwent resection of isolated metachronous lung metastases from colorectal cancer. Three-year DFS after pulmonary metastasectomy was similar to that after hepatic metastasectomy (50.7% vs. 45.5%, respectively; p=0.58). Rectal cancer (hazard ratio [HR]: 2.04, 95% confidence interval [CI]: 1.09-3.79; p=0.03) and ≥2 metastases (HR: 2.17, 95% CI: 1.28-3.68; p=0.004) were independent adverse risk factors associated with disease-free survival after pulmonary metastasectomy on multivariate analysis. Three-year DFS for colon vs. rectal cancer patients was 72.5% vs. 42.6%, respectively (p=0.04). The number of lung metastases was an independent risk factor for DFS after pulmonary metastasectomy in rectal cancer patients.

PATIENTS AND METHODS:

Patients who underwent lung metastasectomy after curative resection of colorectal cancers were investigated. Disease-free survival (DFS) after pulmonary metastasectomy was compared to that after hepatic metastasectomy, which has a relatively well-known prognosis. Multivariate Cox proportional hazards analysis was performed to identify clinical variables predictive of survival after pulmonary metastasectomy.

CONCLUSIONS:

Disease-free survival rates after resection of lung vs. liver metastases arising from colorectal cancers are similar. However, lung metastases specifically from rectal cancers produce poorer DFS rates. Primary tumor location must be considered for pulmonary metastasis treatment and follow-up in colorectal cancer patients.

• Authors: Jee Yeon Kim, In Ja Park, Hyeong Ryul Kim, Dong Kwan Kim, Jong Lyul Lee, Yong Sik Yoon, Chan Wook Kim, Seok-Byung Lim, Jung Bok Lee, Chang Sik Yu, Jin Cheon Kim
• Journal: Oncotarget (Oncotarget) Vol. 8 Issue 22 Pg. 36566-36577 (May 30 2017) ISSN: 1949-2553 [Electronic] United States
• PMID: 28402263 (Publication Type: Journal Article)

Chemical References

• Biomarkers, Tumor

Topics

• Adolescent
• Adult
• Aged
• Biomarkers, Tumor (genetics)
• Child
• Colorectal Neoplasms (genetics, mortality, pathology, surgery)
• Combined Modality Therapy
• Female
• Humans
• Lung Neoplasms (secondary)
• Male
• Metastasectomy (methods)
• Microsatellite Instability
• Middle Aged
• Mutation
• Neoplasm Staging
• Postoperative Period
• Prognosis
• Retreatment
• Risk Factors
• Treatment Outcome
• Young Adult