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Repeated Resection of Colorectal Cancer Pulmonary Oligometastases: Pooled Analysis and Prognostic Assessment |
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| Authors: | Samer Salah MD Kazuhiro Watanabe MD PhD Joon Suk Park MD Alaa Addasi MD Ji Won Park MD Jon Zabaleta MD Francesco Ardissone MD Jhingook Kim MD PhD Marc Riquet MD PhD Kazunori Nojiri MD PhD Mara Gisabella MD Sun Young Kim MD Kuniya Tanaka MD PhD |
| Affiliation: | 1. Medical Oncology Department, King Hussein Cancer Center, Amman, Jordan 2. Department of Surgery, Tohoku University, Sendai, Japan 3. Department of Surgical Oncology, National Cancer Center Hospital East, Chiba, Japan 4. Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea 5. Center for Colorectal Cancer, National Cancer Center, Gyeonggi-do, Korea 6. Thoracic Surgery Service, Hospital Donostia, San Sebastian, Spain 7. Department of Clinical and Biological Sciences, Thoracic Surgery Unit, University of Turin, San Luigi Hospital, Orbassano, Torino, Italy 8. Department of Thoracic Surgery, Georges Pompidou European Hospital, Paris-Descartes University, Paris, France 9. Department of Gastroenterological Surgery, Yokohama City University, Yokohama City, Japan |
| Abstract: | BackgroundRepeated resection of colorectal cancer pulmonary metastasis is associated with long-term survival. Nevertheless, very limited data addressing the best candidates for repeated pulmonary resection is available.Patients and MethodsWe searched the PubMed database for retrospective studies evaluating lung metastasectomy for metastatic colorectal cancer (CRC). We included studies with available data about repeated pulmonary metastasectomy. Potential prognostic factors were analyzed for possible impact on survival following the second metastasectomy through univariate and multivariate analysis.ResultsBetween 1983 and 2008, 944 lung metastasectomies were carried out on 759 patients. Of those, 148 patients had a second metastasectomy. The 5-year survival rate was 52 % for patients who had 1 metastasectomy and 57.9 % from the second metastasectomy for patients who had repeated resection. More than 2 metastatic pulmonary nodules and maximum diameter of largest pulmonary nodule ≥3 cm were the only independent factors associated with inferior survival following repeated pulmonary resection.ConclusionsIn selected patients with metastatic CRC, repeated pulmonary metastasectomy offers an excellent chance for long-term survival and is associated with a quite low operative mortality. Patients with more than 2 metastatic nodules and a maximum diameter of the largest metastatic lung nodule of ≥3 cm have a significantly inferior survival. |
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