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International Journal of Colorectal Disease

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01-01-2020 | Metastasis | Original Article

Lung metastasectomy after colorectal cancer: prognostic impact of resection margin on long term survival, a retrospective cohort study

Authors: Federico Davini, Sara Ricciardi, Carmelina C. Zirafa, Gaetano Romano, Greta Alì, Gabriella Fontanini, Franca M.A. Melfi

Published in: International Journal of Colorectal Disease | Issue 1/2020

Abstract

Background

Pulmonary metastasectomy is considered a potentially curative treatment for selected patients with metastatic colorectal cancer (CRC). Several prognostic factors have been analysed, but to date, it is still not well defined which is the optimal resection margin during lung metastasectomy (LM). This study analyses the long-term results and prognostic factors after LM in CRC patients with particular attention to the resection margins. Primary endpoint of this study is to assess the correlation between resection margins and long-term outcomes.

Methods

Observational cohort study on all proven cases of CRC lung metastases (2000–2016) resected with curative intent in a single centre.

Results

The series included 210 consecutive patients (M/F 133/77) with a mean age of 65.4 (± 9.96) years, 75% (159/210) of them with a solitary metastasis. Mean size of metastasis was 2.57 cm (± 1.45). One hundred sixty-eight patients underwent wedge resections (80%) and lymphadenectomy was carried out in 90 cases (42.9%). With a mean follow-up of 56 months (range 5–192), we observed a 1-, 3- and 5-year overall survival (OS) of 95%, 74% and 54%, respectively. The patients were divided into three groups according to the resection margin distance from the tumour: (a) ≥ 2 cm (145 cases); (b) < 2, ≥ 1 cm (37 cases); and (c) < 1 cm (12 cases). The OS was significantly different between the three groups (p = 0,020); univariate and multivariate analyses showed that a narrow resection margin was an independent prognostic factor of worse survival (p = 0.006 and HR 3.4 p = 0.009).

Conclusions

Long-term survival of patients after LM is strongly associated with a greater distance between the lesion and the resection margin.

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Title: Lung metastasectomy after colorectal cancer: prognostic impact of resection margin on long term survival, a retrospective cohort study
Authors: Federico Davini
Sara Ricciardi
Carmelina C. Zirafa
Gaetano Romano
Greta Alì
Gabriella Fontanini
Franca M.A. Melfi
Publication date: 01-01-2020
Publisher: Springer Berlin Heidelberg
Keywords: Metastasis
Colorectal Cancer
Colorectal Cancer
Published in: International Journal of Colorectal Disease / Issue 1/2020
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-019-03386-z

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Springer Medicine

Lung metastasectomy after colorectal cancer: prognostic impact of resection margin on long term survival, a retrospective cohort study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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