Outcomes after resection of synchronous or metachronous hepatic and pulmonary colorectal metastases

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4059-4059
Author(s):  
G. Miller ◽  
P. Biernacki ◽  
N. Kemeny ◽  
M. Gonen ◽  
R. Downey ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Cox Regression ◽  
Pulmonary Metastases ◽  
Hepatic Metastases ◽  
Colorectal Metastases ◽  
Patient Treatment ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free ◽  
Pulmonary Colorectal Metastases

4059 Background: Surgical resection of isolated hepatic or pulmonary colorectal metastases prolongs survival in selected patients. However, the benefits of resection and appropriate selection criteria in patients who develop both hepatic and pulmonary metastases are ill-defined. Methods: Data were prospectively collected from 131 patients with colorectal cancer who underwent resection of both hepatic and pulmonary metastases over a 20-year period. Median follow-up was 6.6 years from the time of resection of the primary tumor. Patient, treatment, and outcome variables were analyzed using log-rank, Cox regression, and Kaplan-Meier methods. Results: The site of first metastasis was the liver in 65% of patients, lung in 11%, and both simultaneously in 24%. Multiple hepatic metastases were present in 51% of patients and multiple pulmonary metastases were found in 48%. Hepatic lobectomy or trisegmentectomy was required in 61% of patients while most lung metastases (80%) were treated with wedge excisions. Median survival from resection of the primary disease, first site of metastasis, and second site of metastasis was 6.9, 5.0, and 3.3 years, respectively. After resection of disease at the second site of metastasis, the 1, 3, 5, and 10 year disease-specific survival rates were 91, 55, 31 and 19%, respectively. An analysis of prognostic factors revealed that survival was significantly longer when the disease-free interval between the development of the first and second sites of metastases exceeded one year, in patients with a single liver metastasis, and in patients younger than 55 years. Conclusions: Surgical resection of both hepatic and pulmonary colorectal metastases is associated with prolonged survival in selected patients. Patients with a longer disease free interval between metastases and those with single liver lesions had the best outcomes. [Table: see text] No significant financial relationships to disclose.

Survival outcomes after surgical resection of pulmonary metastases of head and neck tumours

2016 ◽  
Vol 130 (3) ◽  
pp. 291-295 ◽  
Author(s):  
S Hosokawa ◽  
K Funai ◽  
K Sugiyama ◽  
G Takahashi ◽  
J Okamura ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck ◽  
Surgical Resection ◽  
Pulmonary Metastases ◽  
Clinical Staging ◽  
Disease Free Interval ◽  
Head And Neck Malignancies ◽  
Free Interval ◽  
Pathological Subtype ◽  
Disease Free

AbstractBackground:There is limited information available regarding the benefits and outcomes of resection of pulmonary metastases arising from head and neck cancers.Methods:A retrospective review was performed of 21 patients who underwent resection of pulmonary metastases of primary head and neck malignancies at Hamamatsu University Hospital. Clinical staging, treatment methods, pathological subtype (particularly squamous cell carcinoma), disease-free interval and overall survival were evaluated.Results:The 5- and 10-year overall survival rates of the study participants were 67.0 per cent and 55.0 per cent, respectively, as determined by the Kaplan–Meier method. The prognosis for patients with a disease-free interval of less than 24 months was poor compared to those with a disease-free interval of greater than 24 months (p = 0.0234).Conclusion:Patients with short disease-free intervals, and possibly those who are older than 60 years, should be categorised as having severe disease. However, pulmonary metastases from head and neck malignancies are potentially curable by surgical resection.

Prognostic factors for colorectal cancer patients with pulmonary metastases

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15107-e15107
Author(s):  
W. Li ◽  
W. Zhang ◽  
S. Cai ◽  
J. Yin ◽  
J. Li
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Primary Tumor ◽  
Pulmonary Metastases ◽  
Good Survival ◽  
Primary Tumor Site ◽  
Disease Free Interval ◽  
Metastatic Site ◽  
Free Interval ◽  
Disease Free

e15107 Background: Pulmonary is the second common metastastic site of CRC with a good survival after metastasectomy, however the general situation of pulmonary metastases from CRC has received little attention, especially for unresectable ones. The aim of this study was to determine factors that may influence survival and disease free interval from primary radical surgery to pulmonary metastases (DFI). Methods: From 01/2000 to 11/2008, a total of 206 pts with pulmonary metastases (colon72, rectal ca131, 3 unknown) were collected retrospectively and the clinical data were analyzed using Kaplan-Meier survival curves, univariate and multivariate analysis. Results: 128 pts (62.1%) had lung disease as the first metastatic site and 33 pts (26.7%) had synchronous liver involvement. Only 17 patients (8.3%) followed pulmonary metastatic resection, and others underwent palliative medical treatment including the chemotherapy and intervention. Median survival was 16.0 months (range 12.240–19.760) with a 18% 5-year survival. Of the totally 160 patients who had synchronous pulmonary metastases after radical primary tumor surgery, the mDFI was 20 months (range 16.738–23.262) months. Rectal cancer had a high chance (65%) for lung recurrence with longer DFI (21 vs 14 mo, P=0.02), but no difference of survival was shown compared to colon cancer. Factors that significantly predicted a poor prognosis on univariate analysis included vessel invasion (P=0.022) and high T stage (P=0.009), but neither of them was the independent prognostic factors after multivariate analysis. The factors influencing the DFI of metachronous pulmonary metastases included primary tumor site, pathological morphology, tumor infiltration stage and regional lymph node stage (P<0.05). There was a trend of better survival of patients receiving resection surgery after pulmonary metastases than receiving chemotherapy alone though no statistical significant was reached (mOS:34 vs 16 mo, P=0.125). But to patients who receiving metastatic site resection, chemotherapy after surgery improved the survival (P=0.042). Conclusions: No independent prognostic factors of survival had been found. The invasive tumor with high stage may have a shorter disease free interval of pulmonary metastases after primary surgery. No significant financial relationships to disclose.

804 Does Neoadjuvant Chemotherapy with FOLFOX- or FOLFIRI Improve the Disease-Free Interval or Survival of Patients with Colorectal Metastases?

2009 ◽  
Vol 136 (5) ◽  
pp. A-878
Author(s):  
Sarah Y. Boostrom ◽  
David Nagorney ◽  
John H. Donohue ◽  
Florencia G. Que ◽  
Michael L. Kendrick ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Colorectal Metastases ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free

scholarly journals Insular Glioma Esoteric Precinct

2020 ◽  
Vol 24 (2) ◽  
Author(s):  
FAUZIA SAJJAD ◽  
MUHAMMAD ASIF SHABBIR ◽  
MUHAMMAD AKMAL ◽  
ZAIN SALEH ◽  
ADEEB-UL- HASSAN
Keyword(s):  
Surgical Resection ◽  
Neurological Deficits ◽  
Total Resection ◽  
Motor Weakness ◽  
Disease Free Interval ◽  
Eloquent Areas ◽  
Free Interval ◽  
Operative Complications ◽  
Grade Ii ◽  
Disease Free

Background and Objective:  The complex insular anatomy and its proximity to eloquent areas make this area almost inaccessible for safe surgical resection of Glioma. Aim of our study is to determine outcome assessment after surgical resection. Materials & Methods:  This was a retrospective analysis of 59 patients over a period of 5 years from July 2013 till June 2018. All patients of insular Glioma were included in our study irrespective of age and sex. Degree of surgical resection, Post-operative neurological deficits and complications were assessed. They were followed in the outpatient department at 3, 6 and 12 months. Results:  Total 59 patients were included 38 (64.40%) male and 21 (35.59%) females. 36 (61%) patients had right sided insular Glioma and 23 (38.98%) have left sided. Seizures were main presentation in 46(77.96%) patients. Trans-sylvian route adopted in 34 (57.6%) patients followed by transcortical route. Near total Resection was Possible in 30 (50.84%) patients and partial in 29 (49.15%) patients. Focal neurological deficits the motor weakness & dysphasia were main post-operative complications in 18 (30.5%) patients. Three (5.08%) patients died. In all grade II and grade III Gliomas no increase in size was discovered on MRI Brain at 6 and 12 months. Conclusion:  Maximum safe resection of insular Glioma with acceptable morbidity is possible with improved overall survival and disease free interval.

Liver resection for colorectal metastases.

1997 ◽  
Vol 15 (3) ◽  
pp. 938-946 ◽  
Author(s):  
Y Fong ◽  
A M Cohen ◽  
J G Fortner ◽  
W E Enker ◽  
A D Turnbull ◽  
...  
Keyword(s):  
Survival Rate ◽  
Liver Resection ◽  
Mortality Rate ◽  
Liver Metastases ◽  
Colorectal Metastases ◽  
Extrahepatic Disease ◽  
Disease Free Interval ◽  
Multiple Tumors ◽  
Free Interval ◽  
Disease Free

PURPOSE More than 50,000 patients in the United States will present each year with liver metastases from colorectal cancers. The current study was performed to determine if liver resection for colorectal metastases is safe and effective and to evaluate predictors of outcome. MATERIALS AND METHODS Data for 456 consecutive resections performed between July 1985 and December 1991 in a tertiary referral center were analyzed. RESULTS The perioperative mortality rate was 2.8%, with a mortality rate of 4.6% for resections that involved a lobectomy or more. The median hospital stay was 12 days and only 9% of patients were admitted to the intensive care unit. The 5-year survival rate is 38%, with a median survival duration of 46 months. By univariate analysis, nodal status of the primary lesion, short disease-free interval before detection of liver metastases, carcinoembryonic antigen (CEA) level greater than 200 ng/mL, multiple liver tumors, extrahepatic disease, large tumors, or positive resection margin was predictive of poorer outcome. Sex, age greater than 70 years, site of primary tumor, or perioperative transfusion was not predictive of outcome. By multivariate analysis, positive margin, size greater than 10 cm, disease-free interval less than 12 months, multiple tumors, and extrahepatic disease were independent predictors of poorer outcome. Short disease-free interval or multiple tumors were nevertheless associated with a 5-year survival rate greater than 24%. CONCLUSION Liver resection for colorectal metastases is safe and effective therapy and currently represents the only potentially curative therapy for metastatic colorectal cancer. The only absolute contraindication to resection is extrahepatic disease. A randomized trial to examine efficacy of surgical resection cannot ethically be performed. Liver resection should be considered standard therapy for all fit patients with colorectal metastases isolated to the liver.

Gene signatures of pulmonary metastases of renal cell carcinoma reflect the disease-free interval and the number of metastases per patient

2009 ◽  
Vol 125 (2) ◽  
pp. 474-482 ◽  
Author(s):  
Daniela Wuttig ◽  
Barbara Baier ◽  
Susanne Fuessel ◽  
Matthias Meinhardt ◽  
Alexander Herr ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Pulmonary Metastases ◽  
Disease Free Interval ◽  
Gene Signatures ◽  
Free Interval ◽  
Disease Free

scholarly journals Metastatic Tumors to the Colon and Rectum: A Multi-Institutional Study

2012 ◽  
Vol 136 (11) ◽  
pp. 1397-1401 ◽  
Author(s):  
Najat Mourra ◽  
Anne Jouret-Mourin ◽  
Thierry Lazure ◽  
Virginie Audard ◽  
Laurence Albiges ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Malignant Tumors ◽  
Complementary Therapy ◽  
Colorectal Metastases ◽  
Disease Free Interval ◽  
Secondary Tumors ◽  
Colorectal Mucosa ◽  
Free Interval ◽  
Disease Free

Context.—Unlike the small bowel, the colorectal mucosa is seldom the site of metastatic disease. Objective.—To determine the incidence of truly colorectal metastases, and subsequent clinicopathologic findings, in a substantial colorectal cancer population collected from 7 European centers. Design.—During the last decade, 10 365 patients were identified as having colorectal malignant tumors, other than systemic diseases. Data collected included patient demographics, clinical symptoms, treatment, the presence of metastases in other sites, disease-free interval, follow-up, and overall survival. All secondary tumors resulting from direct invasion from malignant tumors of the contiguous organs were excluded, as well as those resulting from lymph node metastases or peritoneal seeding. Results.—Only 35 patients were included (10 men) with a median age of 59 years. They presented with obstruction, bleeding, abdominal pain, or perforation. The leading source of metastases was the breast, followed by melanoma. Metastases were synchronous in 3 cases. The mean disease-free interval for the remaining cases was 6.61 years. Surgical resection was performed in 28 cases. Follow-up was available for 26 patients; all had died, with a mean survival time of 10.67 months (range, 1–41 months). Conclusions.—Colorectal metastases are exceptional (0.338%) with the breast as a leading source of metastases; they still represent a late stage of disease and reflect a poor prognosis. Therefore, the pathologist should be alert for the possibility of secondary tumors when studying large bowel biopsies. Any therapy is usually palliative, but our results suggest that prolonged survival after surgery and complementary therapy can be obtained in some patients.

scholarly journals The Disease-Free Interval Between Resection of Primary Colorectal Malignancy and the Detection of Hepatic Metastases Predicts Disease Recurrence But Not Overall Survival

2019 ◽  
Vol 26 (9) ◽  
pp. 2812-2820 ◽  
Author(s):  
Diederik J. Höppener ◽  
Pieter M. H. Nierop ◽  
Martinus J. van Amerongen ◽  
Pim B. Olthof ◽  
Boris Galjart ◽  
...  
Keyword(s):  
Overall Survival ◽  
Hepatic Metastases ◽  
Disease Recurrence ◽  
Disease Free Interval ◽  
Colorectal Malignancy ◽  
Free Interval ◽  
Disease Free
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