Top

Published in:

01-04-2018 | Original Scientific Report

Clinical and Radiological Discrimination of Solitary Pulmonary Lesions in Colorectal Cancer Patients

Authors: Yoichi Ohtaki, Kimihiro Shimizu, Toshiteru Nagashima, Seshiru Nakazawa, Kai Obayashi, Yoko Azuma, Misaki Iijima, Takayuki Kosaka, Toshiki Yajima, Hiroomi Ogawa, Soichi Tsutsumi, Motohiro Arai, Akira Mogi, Hiroyuki Kuwano

Published in: World Journal of Surgery | Issue 4/2018

Abstract

Objectives

The lung is one of the most common organs of metastasis from colorectal cancer (CRC), and we have encountered lung cancer patients with a history of CRC. There have been few studies regarding methods used to discriminate between primary lung cancer (PLC) and pulmonary metastasis from CRC (PM-CRC) based only on preoperative findings. We retrospectively investigated predictive factors discriminating between these lesions in patients with a history of CRC.

Methods

Between 2006 and 2015, 117 patients with a history of CRC (44 patients with 47 PLC and 73 patients with 102 PM-CRC) underwent subsequent or concurrent resection of pulmonary lesions. We compared the clinical and radiological characteristics of 100 patients with solitary lesions (43 PLC and 57 PM-CRC). Using univariate and multivariate analyses, we examined predictive factors for discrimination of these two lesions.

Results

All tumors with findings of ground-glass opacity (GGO) were PLC (n = 19). In a multivariate analysis of 81 radiologically solid tumors, two factors were found to be significant independent predictors of PLC: a history of stage I CRC and presence of pleural indentation. All tumors in 26 patients with either GGO or both a stage I CRC history and pleural indentation were PLC, while most tumors in patients without all three factors were PM-CRC (43/44; 97.7%).

Conclusions

The presence or absence of GGO, pathological CRC stage, and pleural indentation could be useful factors to distinguish between PLC and PM-CRC.

Available only for authorised users

Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J et al (2013) Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 49:1374–1403CrossRefPubMed

Sclafani F, Incarbone M, Rimassa L et al (2013) The role of hepatic metastases and pulmonary tumor burden in predicting survival after complete pulmonary resection for colorectal cancer. J Thorac Cardiovasc Surg 145:97–103CrossRefPubMed

Sakamoto Y, Sakaguchi Y, Oki E et al (2012) Surgical outcomes after resection of both hepatic and pulmonary metastases from colorectal cancer. World J Surg 36:2708–2713. doi:10.1007/s00268-012-1708-8 CrossRefPubMed

Sakamoto T, Tsubota N, Iwanaga K et al (2001) Pulmonary resection for metastases from colorectal cancer. Chest 119:1069–1072CrossRefPubMed

Renaud S, Falcoz PE, Olland A et al (2015) The intrathoracic lymph node ratio seems to be a better prognostic factor than the level of lymph node involvement in lung metastasectomy of colorectal carcinoma. Interact CardioVasc Thorac Surg 20:215–221CrossRefPubMed

Renaud S, Alifano M, Falcoz PE et al (2014) Does nodal status influence survival? Results of a 19-year systematic lymphadenectomy experience during lung metastasectomy of colorectal cancer. Interact CardioVasc Thorac Surg 18:482–487CrossRefPubMedPubMedCentral

Lin BR, Chang TC, Lee YC et al (2009) Pulmonary resection for colorectal cancer metastases: duration between cancer onset and lung metastasis as an important prognostic factor. Ann Surg Oncol 16:1026–1032CrossRefPubMed

Cho S, Song IH, Yang HC et al (2013) Prognostic factors of pulmonary metastasis from colorectal carcinoma. Interact CardioVasc Thorac Surg 17:303–307CrossRefPubMedPubMedCentral

Chen F, Hanaoka N, Sato K et al (2009) Prognostic factors of pulmonary metastasectomy for colorectal carcinomas. World J Surg 33:505–511. doi:10.1007/s00268-008-9875-3 CrossRefPubMed

10.

Watanabe I, Arai T, Ono M et al (2003) Prognostic factors in resection of pulmonary metastasis from colorectal cancer. Br J Surg 90:1436–1440CrossRefPubMed

11.

Hattori A, Suzuki K, Aokage K et al (2014) Prognosis of lung cancer patients with a past history of colorectal cancer. Jpn J Clin Oncol 44:1088–1095CrossRefPubMed

12.

Cahan WG, Castro EB, Hajdu SI (1974) Proceedings: the significance of a solitary lung shadow in patients with colon carcinoma. Cancer 33:414–421CrossRefPubMed

13.

Collins J, Stern EJ (2008) Chest radiology: the essentials. Wolters Kluwer Health, Philadelphia

14.

TNM Classification of Malignant Tumours, 7th edn (2009) Wiley

15.

Bishop JA, Sharma R, Illei PB (2010) Napsin a and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma. Hum Pathol 41:20–25CrossRefPubMed

16.

Chhieng DC, Cangiarella JF, Zakowski MF et al (2001) Use of thyroid transcription factor 1, pe-10, and cytokeratins 7 and 20 in discriminating between primary lung carcinomas and metastatic lesions in fine-needle aspiration biopsy specimens. Cancer 93:330–336CrossRefPubMed

17.

Yatabe Y, Mitsudomi T, Takahashi T (2002) Ttf-1 expression in pulmonary adenocarcinomas. Am J Surg Pathol 26:767–773CrossRefPubMed

18.

Lindell RM, Hartman TE, Swensen SJ et al (2007) Five-year lung cancer screening experience: CT appearance, growth rate, location, and histologic features of 61 lung cancers. Radiology 242:555–562CrossRefPubMed

19.

Usuda K, Saito Y, Sagawa M et al (1994) Tumor doubling time and prognostic assessment of patients with primary lung cancer. Cancer 74:2239–2244CrossRefPubMed

20.

Sakurai H, Nakagawa K, Watanabe S et al (2015) Clinicopathologic features of resected subcentimeter lung cancer. Ann Thorac Surg 99:1731–1738CrossRefPubMed

21.

Watanabe K, Saito N, Sugito M et al (2013) Incidence and predictive factors for pulmonary metastases after curative resection of colon cancer. Ann Surg Oncol 20:1374–1380CrossRefPubMed

22.

Tanaka K, Shimizu K, Ohtaki Y et al (2013) Diagnosis and surgical resection of solitary pulmonary nodules in patients with breast cancer. Mol Clin Oncol 1:117–123CrossRefPubMed

23.

Gaeta M, Volta S, Scribano E et al (1996) Air-space pattern in lung metastasis from adenocarcinoma of the GI tract. J Comput Assist Tomogr 20:300–304CrossRefPubMed

24.

Okita R, Yamashita M, Nakata M et al (2005) Multiple ground-glass opacity in metastasis of malignant melanoma diagnosed by lung biopsy. Ann Thorac Surg 79:e1–e2CrossRefPubMed

Title: Clinical and Radiological Discrimination of Solitary Pulmonary Lesions in Colorectal Cancer Patients
Authors: Yoichi Ohtaki
Kimihiro Shimizu
Toshiteru Nagashima
Seshiru Nakazawa
Kai Obayashi
Yoko Azuma
Misaki Iijima
Takayuki Kosaka
Toshiki Yajima
Hiroomi Ogawa
Soichi Tsutsumi
Motohiro Arai
Akira Mogi
Hiroyuki Kuwano
Publication date: 01-04-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 4/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4243-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Clinical and Radiological Discrimination of Solitary Pulmonary Lesions in Colorectal Cancer Patients

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2018

Welcome New Associate Editor Anthony Kim to the World Journal of Surgery

Impact of Splenic Volume and Splenectomy on Prognosis of Hepatocellular Carcinoma Within Milan Criteria After Curative Hepatectomy

Efficacy and Safety of Pleurodesis Using Platelet-Rich Plasma and Fibrin Glue in Management of Postoperative Chylothorax After Esophagectomy

Suitable Ultrasonographic Approach to Assessing Vocal Cord Movement: Reply

Classic Primary Hyperparathyroidism Versus Normocalcemic and Normohormonal Variants: Do They Really Differ?

Effect and Mechanisms of Diabetes Resolution According to the Range of Gastric Resection and the Length of Anastomosis in Animal Models: Implication for Gastric Cancer Surgery in Patients with Diabetes Mellitus