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Role of surgical resection in colorectal lung metastases: analysis of 137 patients

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The aim of this study is to investigate clinicopathologic characteristics and to identify prognostic factors in patients undergoing pulmonary metastasectomy for colorectal carcinoma.

Methods

This study is a single-institution retrospective study of 137 consecutive patients who underwent 158 pulmonary resections for metastatic colorectal carcinoma between January 1989 and June 2008.

Results

Median disease-free interval between colorectal resection and pulmonary metastasectomy was 35.6 months (range, 0.6 to 154.3 months). No perioperative deaths occurred. Follow-up was 100% complete and mean follow-up was 41.6 ± 27.6 months. Median survival was 36.2 months (range, 4.6 to 126 months). Overall 5- and 10-year survival rates were 55.4% and 30.8%, respectively, after pulmonary metastasectomy. At univariate analysis of patient survival, number of lung metastases (p = 0.002), disease-free interval of more than 24 month (p = 0.013), and absence of residual tumor (p = 0.024) were significant prognostic factors. At multivariate analysis, presence of solitary lung metastasis and disease-free interval of more than 24 months remained significant prognostic factors. There was no significant difference in the 5-year survival for 121 patients undergoing single thoracotomy compared with 16 patients undergoing repeated resection(s) for recurrent colorectal lung metastasis (55.1% vs 59.5%; p = 0.79). Nor was the presence of hepatic metastasis associated with lower outcome (p = 0.77).

Conclusions

Disease-free interval and number of metastases are the most significant prognostic factors for survival after pulmonary metastasectomy for colorectal carcinoma. Recurrent pulmonary disease can benefit from repeated resection. Prior hepatectomy for liver involvement does not influence survival.

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Acknowledgements

We would like to thank Valentina Fava, (MSc) and Stefano Panetta, (MSc) for providing invaluable assistance in the statistical data analysis.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Thoracic Surgery Unit, Department of Clinical and Biological Sciences, University of Turin, San Luigi Hospital, Orbassano, 10043, Turin, Italy

    Piero Borasio, Mara Gisabella, Andrea Billé & Francesco Ardissone

  2. Pathology Unit, Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043, Turin, Italy

    Luisella Righi

  3. Pulmonary Oncology Unit, Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043, Turin, Italy

    Marina Longo

  4. Oncology Unit, Department of Clinical and Biological Sciences, University of Turin, Orbassano, 10043, Turin, Italy

    Marco Tampellini

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  1. Piero Borasio
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  2. Mara Gisabella
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  4. Luisella Righi
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  7. Francesco Ardissone
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Correspondence to Francesco Ardissone.

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Borasio, P., Gisabella, M., Billé, A. et al. Role of surgical resection in colorectal lung metastases: analysis of 137 patients. Int J Colorectal Dis 26, 183–190 (2011). https://doi.org/10.1007/s00384-010-1075-6

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  • DOI: https://doi.org/10.1007/s00384-010-1075-6

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