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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2016

01-03-2016 | Thoracic Oncology

Benefit of Adjuvant Chemotherapy After Curative Resection of Lung Metastasis in Colorectal Cancer

Authors: Hyung Soon Park, MD, Minkyu Jung, MD, Sang Joon Shin, MD, PhD, Su Jin Heo, MD, Chang Gon Kim, MD, Min Goo Lee, MD, PhD, Seung Hoon Beom, MD, Chang Young Lee, MD, Jin Gu Lee, MD, PhD, Dae Joon Kim, MD, Joong Bae Ahn, MD, PhD

Published in: Annals of Surgical Oncology | Issue 3/2016

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Abstract

Background

The survival benefit of adjuvant chemotherapy after colorectal cancer (CRC) lung metastasectomy is uncertain.

Methods

We enrolled 221 CRC patients who underwent pulmonary metastasectomy between October 2002 and July 2013, including those with previous liver metastasis that had been curatively resected. Disease-free survival (DFS) and overall survival (OS) were calculated from the day of lung metastasectomy.

Results

Among all patients, 176 (79.6 %) received adjuvant chemotherapy after lung metastasectomy. Median follow-up was 34.7 months from the time of lung metastasectomy [95 % confidence interval (95 % CI), 7.4–90.9 months]. Patients treated with adjuvant chemotherapy had longer DFS compared with surgery alone (median 32.7 vs 11.2 months respectively, P = 0.076). Multivariate analysis revealed previous liver metastasis, preoperative carcinoembryonic antigen ≥5 ng/mL, disease-free interval <24 months, and surgery without adjuvant chemotherapy as independent risk factors for recurrence. Low-risk patients who had 0–1 risk factors received a significant survival benefit from adjuvant chemotherapy [hazard ratio (HR) 0.54; 95 % CI 0.32–0.91, P = 0.020]; however, high-risk patients with ≥2 risk factors did not (HR 1.02; 95 % CI 0.48–2.14, P = 0.964). Patients treated with adjuvant chemotherapy showed no OS benefit compared with patients who received surgery alone (median 89.6 vs 86.8 months respectively, P = 0.833).

Conclusions

CRC patients received lung metastasectomy could have a DFS benefit from adjuvant chemotherapy, especially in low-risk patients. Larger, prospective studies are needed to evaluate the role of adjuvant chemotherapy after CRC lung metastasectomy.
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Metadata
Title
Benefit of Adjuvant Chemotherapy After Curative Resection of Lung Metastasis in Colorectal Cancer
Authors
Hyung Soon Park, MD
Minkyu Jung, MD
Sang Joon Shin, MD, PhD
Su Jin Heo, MD
Chang Gon Kim, MD
Min Goo Lee, MD, PhD
Seung Hoon Beom, MD
Chang Young Lee, MD
Jin Gu Lee, MD, PhD
Dae Joon Kim, MD
Joong Bae Ahn, MD, PhD
Publication date
01-03-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 3/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4951-z

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