Long-term results in patients with lung resections for colorectal cancer metastases. Experience of a single center in Argentina
DOI:
https://doi.org/10.31053/1853.0605.v79.n3.32403Keywords:
neoplasm metastasis, pulmonary surgical procedures, colorectal surgeryAbstract
Introduction: Between 5-10% of patients who undergo curative surgery for colorectal cancer (CRC) will present recurrence of their disease on the lungs. Surgical treatment of pulmonary metastases (PM) has gained popularity over the years, different publications report an overall survival rate at 5 years of between 30% and 60%. We present a review of patients with PM resections of CRC treated in a single center in Argentina.
Materials and methods: A descriptive, observational, retrospective study was conducted between 2008 and 2018. All patients with pulmonary metastasectomy of colorectal cancer were included. The primary endpoint was to evaluate overall survival and disease-free survival. Possible prognostic factors were evaluated as a secondary endpoint.
Results: A total of 99 surgeries were performed in the 68 patients, the resection was multiple in 48.5%, with more than 3 nodules in 13%. Overall and progression-free survival at 5 years was 55% and 27%, respectively. In the statistical analysis we found that the lesions in more than one lobe (p = 0.015) and the resection of more than 3 nodules (p = 0.011) presented a lower overall survival.
Conclusions: in this retrospective analysis we evidenced comparable values to the world literature regarding morbidity, mortality, overall survival and progression-free. In our series, patients with disease in more than one lobe or more than three resected lesions had significantly lower overall survival.
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Zink S, Kayser G, Gabius HJ, Kayser K. Survival, disease-free interval, and associated tumor features in patients with colon/rectal carcinomas and their resected intra-pulmonary metastases. Eur J Cardiothorac Surg. 2001 Jun;19(6):908-13. doi: 10.1016/s1010-7940(01)00724-2.
McCormack PM, Burt ME, Bains MS, Martini N, Rusch VW, Ginsberg RJ. Lung resection for colorectal metastases. 10-year results. Arch Surg. 1992 Dec;127(12):1403-6. doi: 10.1001/archsurg.1992.01420120037006.
Pihl E, Hughes ES, McDermott FT, Johnson WR, Katrivessis H. Lung recurrence after curative surgery for colorectal cancer. Dis Colon Rectum. 1987 Jun;30(6):417-9. doi: 10.1007/BF02556487.
Lee WS, Yun SH, Chun HK, Lee WY, Yun H. Clinical usefulness of chest radiography in detection of pulmonary metastases after curative resection for colorectal cancer. World J Surg. 2007 Jul;31(7):1502-6. doi: 10.1007/s00268-007-9060-0.
Thomford NR, Woolner LB, Clagett OT. The surgical treatment of metastatic tumors in the lungs. J Thorac Cardiovasc Surg. 1965;49: 357–363.
Hishida T, Tsuboi M, Okumura T, Boku N, Ohde Y, Sakao Y, Yoshiya K, Hyodo I, Mori K, Kondo H. Does Repeated Lung Resection Provide Long-Term Survival for Recurrent Pulmonary Metastases of Colorectal Cancer? Results of a Retrospective Japanese Multicenter Study. Ann Thorac Surg. 2017 Feb;103(2):399-405. doi: 10.1016/j.athoracsur.2016.08.084.
Pastorino U. Lung metastasectomy for colorectal cancer. Tumori. 1997 Jan-Feb;83(1 Suppl):S28-30.
Vassallo, B., Smith, D., Bonadeo, F., Benatti, M., Ojea Quintana, G., Vaccaro, C., Specterman, S. Nuestra experiencia en resección de metástasis pulmonares de carcinoma colorrectal. Rev. argent. cir. 2006;91: 139–146.
Caruso, E.S., Vasallo, B.C., Richard, L., Fanti, D., Pallotta, G., Mazzaro, E.L., Dalurzo, M.L. Cirugía de las metástasis pulmonares. Nuestra experiencia. Rev. argent. cir. 1991;61: 8–20.
Seely AJ, Ivanovic J, Threader J, Al-Hussaini A, Al-Shehab D, Ramsay T, Gilbert S, Maziak DE, Shamji FM, Sundaresan RS. Systematic classification of morbidity and mortality after thoracic surgery. Ann Thorac Surg. 2010 Sep;90(3):936-42; discussion 942. doi: 10.1016/j.athoracsur.2010.05.014.
Treasure T, Farewell V, Macbeth F, Monson K, Williams NR, Brew-Graves C, Lees B, Grigg O, Fallowfield L; PulMiCC Trial Group. Pulmonary Metastasectomy versus Continued Active Monitoring in Colorectal Cancer (PulMiCC): a multicentre randomised clinical trial. Trials. 2019 Dec 12;20(1):718. doi: 10.1186/s13063-019-3837-y.
Yokoyama S, Mitsuoka M, Kinugasa T, Hashiguchi T, Matsumoto R, Murakami D, Nishi T, Yoshiyama K, Kashihara M, Takamori S, Akagi Y. Survival after initial lung metastasectomy for metastatic colorectal cancer in the modern chemotherapeutic era. BMC Surg. 2017 May 10;17(1):54. doi: 10.1186/s12893-017-0252-8.
Fournel L, Maria S, Seminel M, Nesci J, Mansuet-Lupo A, Guinet C, Magdeleinat P, Bobbio A, Regnard JF, Alifano M. Prognostic factors after pulmonary metastasectomy of colorectal cancers: a single-center experience. J Thorac Dis. 2017 Oct;9(Suppl 12):S1259-S1266. doi: 10.21037/jtd.2017.04.44.
Zellweger M, Abdelnour-Berchtold E, Krueger T, Ris HB, Perentes JY, Gonzalez M. Surgical treatment of pulmonary metastasis in colorectal cancer patients: Current practice and results. Crit Rev Oncol Hematol. 2018 Jul;127:105-116. doi: 10.1016/j.critrevonc.2018.05.001.
Call S, Rami-Porta R, Embún R, Casas L, Rivas JJ, Molins L, Belda-Sanchís J. Impact of inappropriate lymphadenectomy on lung metastasectomy for patients with metastatic colorectal cancer. Surg Today. 2016 Apr;46(4):471-8. doi: 10.1007/s00595-015-1214-3.
Pagès PB, Serayssol C, Brioude G, Falcoz PE, Brouchet L, Le Pimpec-Barthes F, Thomas PA, Bernard A. Risk factors for survival and recurrence after lung metastasectomy. J Surg Res. 2016 Jun 15;203(2):293-300. doi: 10.1016/j.jss.2016.01.028.
Corona-Cruz JF, Domínguez-Parra LM, Saavedra-Pérez D, Jiménez-Fuentes E, Villarreal-Garza C, Green-Schneeweis L, Ríos-Trejo M, Pachuca D, Martínez-Said H, Guzmán-de-Alba E, Padilla-Rosciano AE, Arrieta O. Lung metastasectomy: long-term outcomes in an 18-year cohort from a single center. Surg Oncol. 2012 Sep;21(3):237-44. doi: 10.1016/j.suronc.2012.05.003.
Poletti GB, Toro IF, Alves TF, Miranda EC, Seabra JC, Mussi RK. Descriptive analysis of and overall survival after surgical treatment of lung metastases. J Bras Pneumol. 2013 Nov-Dec;39(6):650-8. doi: 10.1590/S1806-37132013000600003.
Parsons AM, Detterbeck FC, Parker LA. Accuracy of helical CT in the detection of pulmonary metastases: is intraoperative palpation still necessary? Ann Thorac Surg. 2004 Dec;78(6):1910-6; discussion 1916-8. doi: 10.1016/j.athoracsur.2004.05.065.
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