scholarly journals Pulmonary metastasectomy for colorectal cancer: analysis of prognostic factors affecting survival

2017 ◽  
Vol 9 (S12) ◽  
pp. S1282-S1290 ◽  
Author(s):  
Luca Ampollini ◽  
Letizia Gnetti ◽  
Matteo Goldoni ◽  
Lorenzo Viani ◽  
Elisabetta Faedda ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Pulmonary Metastasectomy ◽  
Factors Affecting

scholarly journals Size of metastatic deposits affects prognosis in patients undergoing pulmonary metastectomy for colorectal cancer

2014 ◽  
Vol 96 (1) ◽  
pp. 32-36 ◽  
Author(s):  
MA Javed ◽  
ARG Sheel ◽  
AA Sheikh ◽  
RD Page ◽  
PS Rooney
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Pulmonary Metastases ◽  
Primary Tumour ◽  
Hepatic Metastases ◽  
Lymph Node Involvement ◽  
R0 Resection ◽  
Hilar Lymph Node ◽  
Poor Prognostic Factor ◽  
Factors Affecting

INTRODUCTION Pulmonary metastectomy for colorectal cancer (CRC) is a well accepted procedure although data regarding indications and prognostic outcomes are inconsistent. This study aimed to analyse our experience with resection of pulmonary CRC metastases to evaluate clinically relevant prognostic factors affecting survival. METHODS A retrospective analysis was undertaken of the records of all patients with pulmonary metastases from CRC who underwent a thoracotomy between 2004 and 2010 at a single surgical centre. RESULTS Sixty-six patients with pulmonary metastases from the colon (n=34) and the rectum (n=32) were identified. The 30-day hospital mortality rate was 0%, with 63 patients undergoing a R0 resection and 3 having a R1 resection. The median survival was 45 months and the cumulative 3-year survival rate was 61%. Size of pulmonary metastasis and ASA (American Society of Anesthesiologists) grade were statistically significant prognostic factors (p=0.047 and p=0.009 respectively) with lesions over 20mm associated with a worse prognosis. Sex, age, site, disease free interval (cut-off 36 months), primary tumour stage, hepatic metastases, number of metastases (solitary vs multiple), type of operation (wedge vs lobe resection), hilar lymph node involvement and administration of adjuvant chemotherapy were not found to be statistically significant prognostic factors. CONCLUSIONS Pulmonary metastectomy has a potential survival benefit for patients with metastatic CRC. Improved survival even in the presence of hepatic metastases or multiple pulmonary lesions justifies aggressive surgical management in carefully selected patients. In our cohort, size of metastatic deposit was a statistically significant poor prognostic factor.

scholarly journals Outcomes and prognostic factors after pulmonary metastasectomy in patients with colorectal cancer with previously resected hepatic metastases

2019 ◽  
Vol 157 (5) ◽  
pp. 2049-2057.e1 ◽  
Author(s):  
Kimihiro Shimizu ◽  
Yoichi Ohtaki ◽  
Takehiro Okumura ◽  
Narikazu Boku ◽  
Hirotoshi Horio ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Hepatic Metastases ◽  
Pulmonary Metastasectomy

scholarly journals Prognostic factors affecting outcomes in multivisceral en bloc resection for colorectal cancer

Clinics ◽  
2017 ◽  
Vol 72 (5) ◽  
pp. 258-264
Author(s):  
CS Nahas ◽  
SC Nahas ◽  
U Ribeiro-Junior ◽  
L Bustamante-Lopez ◽  
CF Marques ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
En Bloc ◽  
Factors Affecting

scholarly journals Prognostic factors in pulmonary metastasectomy and efficacy of repeat pulmonary metastasectomy from colorectal cancer

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Masahiro Fukada ◽  
Nobuhisa Matsuhashi ◽  
Takao Takahashi ◽  
Yoshihiro Tanaka ◽  
Naoki Okumura ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Risk Ratio ◽  
Mediastinal Lymph Node ◽  
Univariate Analysis ◽  
Pulmonary Metastasectomy ◽  
Mediastinal Lymph Node Metastasis ◽  
Node Metastasis

Abstract Background The rate of pulmonary metastasectomy from colorectal cancer (CRC) has increased with recent advances in chemotherapy, diagnostic techniques, and surgical procedures. The purpose of this study was to investigate the prognostic factors for response to pulmonary metastasectomy and the efficacy of repeat pulmonary metastasectomy. Methods This study was a retrospective, single-institution study of 126 CRC patients who underwent pulmonary metastasectomy between 2000 and 2019 at the Gifu University Hospital. Results The 3- and 5-year survival rates were 84.9% and 60.8%, respectively. Among the 126 patients, 26 (20.6%) underwent a second pulmonary metastasectomy for pulmonary recurrence after initial pulmonary metastasectomy. Univariate analysis of survival identified seven significant factors: (1) gender (p = 0.04), (2) past history of extra-thoracic metastasis (p = 0.04), (3) maximum tumor size (p = 0.002), (4) mediastinal lymph node metastasis (p = 0.02), (5) preoperative carcinoembryonic antigen (CEA) level (p = 0.01), (6) preoperative carbohydrate antigen 19-9 (CA19-9) level (p = 0.03), and (7) repeat pulmonary metastasectomy for pulmonary recurrence (p < 0.001). On multivariate analysis, only mediastinal lymph node metastasis (p = 0.02, risk ratio 8.206, 95% confidence interval (CI) 1.566–34.962) and repeat pulmonary metastasectomy for pulmonary recurrence (p < 0.001, risk ratio 0.054, 95% CI 0.010–0.202) were significant. Furthermore, in the evaluation of surgical outcomes, the safety of second pulmonary metastasectomy was almost the same as that of initial pulmonary metastasectomy. Conclusions Repeat pulmonary metastasectomy is likely to be safe and effective for recurrent cases that meet the surgical criteria. However, mediastinal lymph node metastasis was a significant independent prognostic factor for worse overall survival.

Age-specific prognostic factors in patients treated surgically for pulmonary metastases of colorectal cancer: A multi-institutional cumulative follow-up study.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 773-773
Author(s):  
Sayumi Nakao ◽  
Michio Itabashi ◽  
Mamiko Ubukata ◽  
Yoshiko Bamba ◽  
Tomoichiro Hirosawa ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Pulmonary Resection ◽  
Lung Resection ◽  
Colorectal Metastases ◽  
Pulmonary Metastasectomy ◽  
Poor Prognostic Factor ◽  
Elder Patients

773 Background: The aim of this study was to investigate the age-specific prognostic factors for overall survival (OS) and disease-free interval (DFI) after pulmonary metastasectomy for colorectal cancer (CRC). Methods: We performed a retrospective analysis of 1,179 patients who underwent lung resection for colorectal metastases from 2001 to 2012 in 109 affiliated institutions of the Japanese Society for Cancer of the Colon and Rectum study group. The patients were divided into three groups by the age at pulmonary resection: Group A (GA) comprised of 396 patients who underwent lung resection under the age of 60 years old; Group B (GB) comprised of 604 patients who underwent lung resection between the ages of 61 and 74 years old; Group C (GC) comprised of 179 patients who underwent lung resection over the age of 75 years old. We used the Cox proportional hazard regression to identify independent prognostic factors for OS and DFI. Results: Median OS times after pulmonary resection were 45 months, 43 months, and 43 months for GA, GB, and GC, respectively. Two-year and 5-year overall survival rates were 73% and 54% for GA, 77% and 63% for GB, and 82% and 68% for GC, respectively. The independent unfavorable prognostic factors were recurrence after pulmonary resection (p<0.0001) in GA, detection of liver metastases before lung resection (p=0.0126), a high level of carcinoembryonic antigen (p=0.0003), and recurrence after pulmonary resection (p<0.0001) in GB, and recurrence after pulmonary resection (p<0.0001) in GC. Median DFI times were 11 months in all groups. The independent unfavorable prognostic factor was a removal of mediastinal lymph node (p=0.0335) in GB. Conclusions: Elder patients (GC) showed nearly the same OS rate compared with non-elder patients (GB), while younger patients (GA) showed poor OS rate. Recurrence after pulmonary resection revealed to be a poor prognostic factor in all groups.

Prognostic Factors After Pulmonary Metastasectomy for Colorectal Cancer and Rationale for Determining Surgical Indications

2013 ◽  
Vol 257 (6) ◽  
pp. 1059-1064 ◽  
Author(s):  
Tomohiko Iida ◽  
Hiroaki Nomori ◽  
Mitsutoshi Shiba ◽  
Jun Nakajima ◽  
Sakae Okumura ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Pulmonary Metastasectomy ◽  
Surgical Indications
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