Prognostic Factors of Pulmonary Metastasectomy for Colorectal Carcinomas

BACKGROUND: Altered expression of blood group-related carbohydrate antigens such as sialyl Lewis (Le)xantigen in tumours is associated with tumour progression behaviour and subsequent prognosis. However, the prognostic value of the expression of Le-related antigens in colorectal tumours remains unclear.PURPOSE: To clarify the prognostic value of Lea, sialyl Lea, Lexand sialyl Lexexpression in colorectal carcinomas as prognostic factors after surgery.PATIENTS AND METHODS: Colorectal carcinoma samples from 101 patients with primary colorectal carcinoma who underwent surgical resection were subject to immunohistochemical analyses for Lea, sialyl Lea, Lexand sialyl Lexexpression with the respective monoclonal antibodies.RESULTS: Lea, sialyl Lea, Lexand sialyl Lexwere expressed in 69 (68.3%), 73 (72.3%), 66 (65.4%) and 76 (75.3%) carcinomas, respectively. The patients with sialyl Lex-expressing tumours had more advanced cancer than those with nonsialyl Lex-expressing tumours (P=0.0029). The survival time after surgery of patients with Lex- or sialyl Lex-expressing tumours was significantly shorter than the survival time of those with non-Lex- or nonsialyl Lex-expressing tumours, respectively (P=0.023 and P=0.0001, respectively). Cox’s regression analysis revealed that Lexand sialyl Lexexpression, separate from stage and histological type, were prognostic variables for patient survival (hazard ratio [HR] for sialyl Lex-positive expression to sialyl Lex-negative expression 2.90; HR for Lex-positive expression to Lex-negative expression 12.76 in stage I/IV, 0.63 in stage II and 1.69 in stage III).CONCLUSIONS: Lexexpression and sialyl Lexexpression in colorectal carcinomas are each associated with poor prognosis. These variables should be considered in the design of future trials.

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Long-Term Survival and Prognostic Factors of Pulmonary Metastasectomy in Liver Cancer: A Systematic Review and Meta-Analysis

World Journal of Surgery ◽

10.1007/s00268-017-4431-7 ◽

2018 ◽

Vol 42 (7) ◽

pp. 2153-2163 ◽

Cited By ~ 3

Author(s):

Chong Wang ◽

Lei Yang ◽

Zikun Liang ◽

Yaodong Liu ◽

Shuku Liu

Keyword(s):

Systematic Review ◽

Prognostic Factors ◽

Liver Cancer ◽

Meta Analysis ◽

Pulmonary Metastasectomy ◽

Term Survival ◽

Long Term Survival

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Prognostic factors for pulmonary metastasectomy in malignant melanoma: size matters

European Journal of Cardio-Thoracic Surgery ◽

10.1093/ejcts/ezz211 ◽

2019 ◽

Vol 56 (6) ◽

pp. 1104-1109 ◽

Cited By ~ 1

Author(s):

Jan Viehof ◽

Elisabeth Livingstone ◽

Elena Loscha ◽

Paul Stockhammer ◽

Agnes Bankfalvi ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Survival Rate ◽

Malignant Melanoma ◽

Treatment Options ◽

Pulmonary Metastasectomy ◽

Long Term Outcome ◽

Female Patients ◽

Novel Treatment ◽

The Impact

AbstractOBJECTIVESPulmonary metastasectomy for malignant melanoma requires an individualized therapeutic decision. Due to recently developed novel treatment options, the prognosis of patients with melanoma has improved significantly. Validated prognostic factors that identify patients who are most likely to benefit from metastasectomy are urgently needed.METHODSWe retrospectively reviewed all consecutive patients with melanoma undergoing complete pulmonary metastasectomy between January 2010 and December 2016. The impact of age, sex, extrapulmonary metastases, preoperative systemic therapy, number of metastases, laterality and largest diameter of metastasis on survival after metastasectomy was analysed.RESULTSA total of 29 male and 32 female patients were included in the study. The median follow-up time was 25.6 months. The mean number of resected metastases was 1.7 ± 1.1 (range 1–5). Ten patients had repetitive pulmonary metastasectomies. The median survival time was 31.3 months with a 2-year survival rate of 54%. Bilateral metastases or multiple nodules were not associated with a significantly decreased overall survival rate after metastasectomy. Shorter overall survival times were observed in male patients [hazard ratio (HR) 2.9, 95% confidence interval (CI) 1.42–5.92; P = 0.0035] and in patients with nodules larger than 2 cm (HR 3.18, 95% CI 1.45–6.98; P = 0.004). In multivariable analysis, both gender and tumour size remained significant independent prognostic factors.CONCLUSIONSExcellent overall survival rates after pulmonary metastasectomy for melanoma metastases were observed in patients with a metastatic diameter less than 2 cm and in female patients. In view of improved long-term outcome due to novel treatment options, the selection of patients for pulmonary metastasectomy based on prognostic factors will become increasingly important.

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