Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Surgery
Published in: BMC Surgery 1/2010

Open Access 01-12-2010 | Research article

Predicting survival after pulmonary metastasectomy for colorectal cancer: previous liver metastases matter

Authors: Ulrich Landes, John Robert, Thomas Perneger, Gilles Mentha, Vincent Ott, Philippe Morel, Pascal Gervaz

Published in: BMC Surgery | Issue 1/2010

Login to get access

Abstract

Background

Few patients with lung metastases from colorectal cancer (CRC) are candidates for surgical therapy with a curative intent, and it is currently impossible to identify those who may benefit the most from thoracotomy. The aim of this study was to determine the impact of various parameters on survival after pulmonary metastasectomy for CRC.

Methods

We performed a retrospective analysis of 40 consecutive patients (median age 63.5 [range 33-82] years) who underwent resection of pulmonary metastases from CRC in our institution from 1996 to 2009.

Results

Median follow-up was 33 (range 4-139) months. Twenty-four (60%) patients did not have previous liver metastases before undergoing lung surgery. Median disease-free interval between primary colorectal tumor and development of lung metastases was 32.5 months. 3- and 5-year overall survival after thoracotomy was 70.1% and 43.4%, respectively. In multivariate analysis, the following parameters were correlated with tumor recurrence after thoracotomy; a history of previous liver metastases (HR = 3.8, 95%CI 1.4-9.8); and lung surgery other than wedge resection (HR = 3.0, 95%CI 1.1-7.8). Prior resection of liver metastases was also correlated with an increased risk of death (HR = 5.1, 95% CI 1.1-24.8, p = 0.04). Median survival after thoracotomy was 87 (range 34-139) months in the group of patients without liver metastases versus 40 (range 28-51) months in patients who had undergone prior hepatectomy (p = 0.09).

Conclusion

The main parameter associated with poor outcome after lung resection of CRC metastases is a history of liver metastases.
Appendix
Available only for authorised users
Literature
1.
Andres A, Majno PE, Morel P, Rubbia-Brandt L, Giostra E, Gervaz P, Terraz S, Allal AS, Roth AD, Mentha G: Improved long-term outcome of a Improved long-term outcome of surgery for advanced colorectal liver metastases: reasons and implications for management on the basis severity score. An Surg Oncol. 2008, 15: 134-43. 10.1245/s10434-007-9607-1.CrossRef
2.
Ballantyne GH, Quin J: Surgical treatment of liver metastases in patients with colorectal cancer. Cancer. 1993, 71: 4252-66. 10.1002/1097-0142(19930615)71:12+<4252::AID-CNCR2820711815>3.0.CO;2-6.CrossRefPubMed
3.
Fiorentino F, Hunt I, Teoh K, Treasure T, Utley M: Pulmonary metastasectomy in colorectal cancer: a systematic review and quantitative synthesis. J R Soc Med. 2010, 103: 60-6. 10.1258/jrsm.2009.090299.CrossRefPubMedPubMedCentral
4.
Rotolo N, De Monte L, Imperatori A, Dominioni L: Pulmonary resections of single metastases from colorectal cancer. Surg Oncol. 2007, 16 (Suppl 1): S141-4. 10.1016/j.suronc.2007.10.007.CrossRefPubMed
5.
Tan KK, de Lima Lopes G, Sim R: How uncommon are isolated lung metastases in colorectal cancer? A review from database of 754 patients over 4 years. J Gastrointest Surg. 2009, 13: 642-8. 10.1007/s11605-008-0757-7.CrossRefPubMed
6.
Gervaz P, Scholl B, Mainguene C, Poitry S, Gillet M, Wexner S: Angiogenesis of liver metastases: role of sinusoidal endothelial cells. Dis Colon Rectum. 2000, 43: 980-6. 10.1007/BF02237364.CrossRefPubMed
7.
Girard P, Ducreux M, Baldeyrou P, Rougier P, Le Chevalier T, Bougaran J, Lasser P, Gayet B, Ruffié P, Grunenwald D: Surgery for lung metastases from colorectal cancer: analysis of prognostic factors. J Clin Oncol. 1996, 14: 2047-53.PubMed
8.
Watanabe K, Nagai K, Kobayashi A, Sugito M, Saito N: factors influencing survival after complete resection of pulmonary metastases from colorectal cancer. Br J Surg. 2009, 96: 1058-65. 10.1002/bjs.6682.CrossRefPubMed
9.
Pfannschmidt J, Dienemann H, Hoffmann H: Surgical resection of pulmonary metastases from colorectal cancer: a systematic review of published series. Ann Thorac Surg. 2007, 84: 324-38. 10.1016/j.athoracsur.2007.02.093.CrossRefPubMed
10.
Rena O, Casadio C, Viano F, Cristofori R, Ruffini E, Filosso PL, Maggi G: Pulmonary resection for metastases from colorectal cancer: factors influencing prognosis. Twenty- year experience. Eur J Cardiothorac Surg. 2002, 21: 906-12. 10.1016/S1010-7940(02)00088-X.CrossRefPubMed
11.
Takakura Y, Miyata Y, Okajima M, Okada M, Ohdan H: Short disease-free interval is a significant risk factor for intrapulmonary recurrence after resection of pulmonary metastases in colorectal cancer. Colorectal Dis. 2009,
12.
Lin BR, Chang TC, Lee YC, Lee PH, Chang KJ, Liang JT: Pulmonary resection for colorectal cancer metastases: duration between cancer onset and lung metastasis as an important prognostic factor. Ann Surg Oncol. 2009, 16: 1026-32. 10.1245/s10434-008-0286-3.CrossRefPubMed
13.
Onaitis MW, Petersen RP, Haney JC, Saltz L, Park B, Flores R, Rizk N, Bains MS, Dycoco J, D'Amico TA, Harpole DH, Kemeny N, Rusch VW, Downey R: Prognostic factors for recurrence after pulmonary resection of colorectal cancer metastases. Ann Thorac Surg. 2009, 87: 1684-8. 10.1016/j.athoracsur.2009.03.034.CrossRefPubMed
14.
Iisaza T, Suzuki M, Yoshida S, Motohashi S, Yasufuku K, Iyoda A, Shibuya K, Hiroshima K, Nakatani Y, Fujisawa T: Prediction of prognosis an surgical indications for pulmonary metastasectomy from colorectal cancer. Ann Thorac Surg. 2006, 82: 254-60. 10.1016/j.athoracsur.2006.02.027.CrossRef
15.
Inoue M, Ohta M, Iuchi K, Fujiwara K, Fukuhara K, Yasumitsu T: Surgery for pulmonary metastases from colorectal cancer. Ann Thorac Surg. 2000, 70: 380-3. 10.1016/S0003-4975(00)01417-X.CrossRefPubMed
16.
Pfannschmidt J, Muley T, Dienemann H, Hoffmann H: Prognostic factors and survival after complete resection of pulmonary metastases from colorectal carcinoma: experiences in 167 patients. J Thorac Cardiovasc Surg. 2003, 126: 732-9. 10.1016/S0022-5223(03)00587-7.CrossRefPubMed
17.
Vogelsang H, Haas S, Hierholzer C, Berger U, Siewert JR, Prauer H: Factors influencing survival after resection of pulmonary metastases from colorectal cancer. Br J Surg. 2004, 91: 1066-71. 10.1002/bjs.4602.CrossRefPubMed
18.
Koga R, Yamamoto J, Saiura A, Yamaguchi T, Hata E, Sakamoto M: Surgical resection of pulmonary metastases from colorectal cancer: four favourable prognostic factors. Jpn J Clin Oncol. 2006, 36: 643-8. 10.1093/jjco/hyl076.CrossRefPubMed
19.
Welter S, Jacobs J, Krbek T, Poettgen C, Stamatis G: Prognostic impact of lymph node involvement in pulmonary metastases from colorectal cancer. Eur J Cardiothorac Surg. 2007, 31: 167-72. 10.1016/j.ejcts.2006.11.004.CrossRefPubMed
20.
Saito Y, Omiya H, Kohno K, Kobayashi T, Itoi K, Teramachi M, Sasaki M: Pulmonary metastasectomy for 165 patients with colorectal carcinoma. A prognostic assessment. J Thorac Cardiovasc Surg. 2002, 124: 1007-13. 10.1067/mtc.2002.125165.CrossRefPubMed
21.
Castaing D, Vibert E, Ricca L, Azoulay D, Adam R, Gayet B: Oncologic results of laparoscopic versus open hepatectomy in two specialized centers. Ann Surg. 2009, 250: 849-55. 10.1097/SLA.0b013e3181bcaf63.CrossRefPubMed
22.
Joosten J, Bertholet J, Keemers-Gel M, Barendregt W, Ruers T: Pulmonary resection of colorectal metastases in patients with or without a history of hepatic metastases. Eur J Surg Oncol. 2008, 34: 895-9.CrossRefPubMed
23.
Neeff H, Horth W, Makowiec F, Fischer E, Imdahl A: Outcome after resection of hepatic and pulmonary metastases of colorectal cancer. J Gastrointest Surg. 2009, 13: 1813-20. 10.1007/s11605-009-0960-1.CrossRefPubMed
24.
Riquet M, Foucault C, Cazes A, Mitry E, Dujon A, Le Pimpec Barthes F: Pulmonary resection for metastases of colorectal adenocarcinoma. Ann Thorac Surg. 2010, 89: 375-80. 10.1016/j.athoracsur.2009.10.005.CrossRefPubMed
25.
Yedibela S, Klein P, Feuchter K, Hoffmann M, Meyer T, Papadopoulos T, Gohl J, Hohenberger W: Surgical management of pulmonary metastases from colorectal cancer in 153 patients. Ann Surg Oncol. 2006, 13: 1538-44. 10.1245/s10434-006-9100-2.CrossRefPubMed
26.
Kanemitsu Y, Kato T, Hirai T, Yasui K: Preoperative probability model for predicting overall survival after resection of pulmonary metastases from colorectal cancer. Prognostic factors of pulmonary metastasectomy for colorectal carcinomas. World J Surg. 2009, 33: 505-11. 10.1007/s00268-008-9875-3.CrossRef
Metadata
Title
Predicting survival after pulmonary metastasectomy for colorectal cancer: previous liver metastases matter
Authors
Ulrich Landes
John Robert
Thomas Perneger
Gilles Mentha
Vincent Ott
Philippe Morel
Pascal Gervaz
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2010
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/1471-2482-10-17

Other articles of this Issue 1/2010

BMC Surgery 1/2010 Go to the issue

Study protocol

Decompressive laparotomy with temporary abdominal closure versus percutaneous puncture with placement of abdominal catheter in patients with abdominal compartment syndrome during acute pancreatitis: background and design of multicenter, randomised, controlled study

Research article

Early career choices and successful career progression in surgery in the UK: prospective cohort studies

Research article

Indications and outcome of pediatric tracheostomy: results from a Nigerian tertiary hospital

Case report

Cystic colon duplication causing intussusception in a 25-year-old man: report of a case and review of the literature

Study protocol

A prospective, randomized, double-blinded single-site control study comparing blood loss prevention of tranexamic acid (TXA) to epsilon aminocaproic acid (EACA) for corrective spinal surgery

Research article

Clinicopathological analysis of recurrence patterns and prognostic factors for survival after hepatectomy for colorectal liver metastasis