Pulmonary Resection for Colorectal Cancer Metastases: Duration Between Cancer Onset and Lung Metastasis as an Important Prognostic Factor |
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Authors: | Been-Ren Lin Tung-Chen Chang Yung-Chie Lee Po-Huang Lee King-Jen Chang Jin-Tung Liang |
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Institution: | (1) Division of Colorectal Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, ROC;(2) Division of Chest Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan, ROC |
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Abstract: | Background Pulmonary resection is the most effective treatment available for colorectal lung metastases. However, the characteristics
of those patients most likely to benefit from surgical resection have not yet been adequately clarified. We have made a critical
analysis for the potential prognostic factors and their clinical significance in lung metastasis from colorectal cancer.
Methods We analyzed 63 consecutive patients who underwent curative pulmonary resection for colorectal lung metastases at National
Taiwan University Hospital from January 1997 to December 2006. Median follow-up was 37.3 (range 12–122) months. Disease-free
and overall survival rates were evaluated by Kaplan–Meier analysis, and multivariate analyses of various prognostic characteristics
were performed.
Results Overall 5-year survival and disease-free survival rates were 43.9% and 19.5%, respectively. Multivariate analysis showed that
the interval for development of lung metastases from primary colorectal cancer and the mode of operation were the only two
independent prognostic factors for survival. With regard to disease-free survival, the interval between initial resection
of colorectal cancer and following lung metastases was the only significant independent prognostic factor. Besides, subset
analysis showed that the 5-year survival rate in repeated resection group for recurrence of colorectal metastasis in residual
lung was 85.7%.
Conclusion Pulmonary resection, initial or even repeated resection for metastatic tumor from colorectal cancer should be encouraged for
selected patients as it can significantly improve survival. Patients who have lung metastases within 1 year after primary
tumor resection and those who do not undergo anatomical resection for metastatic lung tumor should be followed more carefully
due to poor prognosis. |
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