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01-06-2013

Outcomes After Hepatic and Pulmonary Metastasectomies Compared With Pulmonary Metastasectomy Alone in Patients With Colorectal Cancer Metastasis to Liver and Lungs

Authors: Norifumi Hattori, Yukihide Kanemitsu, Koji Komori, Yasuhiro Shimizu, Tsuyoshi Sano, Yoshiki Senda, Tetsuya Mitsudomi, Takayuki Fukui

Published in: World Journal of Surgery | Issue 6/2013

Abstract

Background

Surgical resection is the most effective treatment for colorectal cancer that has metastasized to the liver. Similarly, surgical resection improves survival for selected patients with pulmonary colorectal metastases. However, the indication for pulmonary metastasectomy is not clear in patients with both hepatic and pulmonary colorectal metastases. Therefore, we evaluated outcomes after pulmonary resection of colorectal metastases in patients with or without a history of curative hepatic metastasectomy.

Methods

We retrospectively analyzed 96 patients who underwent pulmonary metastasectomy from March 1999 to November 2009. Patients were grouped according to treatment: resection of pulmonary metastases alone (lung metastasectomy group) or resection of both hepatic and pulmonary metastases (liver and lung metastasectomy group). Overall survival (OS) and disease-free survival (DFS) were evaluated by Kaplan–Meier analysis. Survival curves were compared using the log-rank test.

Results

The 5-year OS for all patients was 61.3 %, and the 5-year DFS was 26.7 %. Group comparisons showed that the 5-year OS of the lung metastasectomy group was significantly better than that of the liver and lung metastasectomy group (69 vs. 43 %; p = 0.030). However, the 5-year DFS rates of the lung metastasectomy group (25.8 %) and liver and lung metastasectomy group (28.0 %) did not differ significantly. Recurrence was higher after resection of both hepatic and pulmonary metastases than after pulmonary metastases alone (79 vs. 45 %; p = 0.025).

Conclusions

Resection of pulmonary colorectal metastases may increase survival. However, the combination of liver and lung metastasectomies had a worse prognosis than pulmonary metastasectomy alone. In selected patients, combined liver and lung metastasectomy can be beneficial and result in acceptable DFS.

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Title: Outcomes After Hepatic and Pulmonary Metastasectomies Compared With Pulmonary Metastasectomy Alone in Patients With Colorectal Cancer Metastasis to Liver and Lungs
Authors: Norifumi Hattori
Yukihide Kanemitsu
Koji Komori
Yasuhiro Shimizu
Tsuyoshi Sano
Yoshiki Senda
Tetsuya Mitsudomi
Takayuki Fukui
Publication date: 01-06-2013
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 6/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-013-1954-4

Keynote webinar | Spotlight on medication adherence

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Outcomes After Hepatic and Pulmonary Metastasectomies Compared With Pulmonary Metastasectomy Alone in Patients With Colorectal Cancer Metastasis to Liver and Lungs

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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