Pulmonary resection for colorectal cancer metastases

Duration between cancer onset and lung metastasis as an important prognostic factor

Been Ren Lin, Tung Chen Chang, Yung Chie Lee, Po Huang Lee, King Jen Chang, Jin Tung Liang

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Background: Pulmonary resection is the most effective treatment available for colorectal lung metastases. However, the characteristics of those patients most likely to benefit from surgical resection have not yet been adequately clarified. We have made a critical analysis for the potential prognostic factors and their clinical significance in lung metastasis from colorectal cancer. Methods: We analyzed 63 consecutive patients who underwent curative pulmonary resection for colorectal lung metastases at National Taiwan University Hospital from January 1997 to December 2006. Median follow-up was 37.3 (range 12-122) months. Disease-free and overall survival rates were evaluated by Kaplan-Meier analysis, and multivariate analyses of various prognostic characteristics were performed. Results: Overall 5-year survival and disease-free survival rates were 43.9% and 19.5%, respectively. Multivariate analysis showed that the interval for development of lung metastases from primary colorectal cancer and the mode of operation were the only two independent prognostic factors for survival. With regard to disease-free survival, the interval between initial resection of colorectal cancer and following lung metastases was the only significant independent prognostic factor. Besides, subset analysis showed that the 5-year survival rate in repeated resection group for recurrence of colorectal metastasis in residual lung was 85.7%. Conclusion: Pulmonary resection, initial or even repeated resection for metastatic tumor from colorectal cancer should be encouraged for selected patients as it can significantly improve survival. Patients who have lung metastases within 1 year after primary tumor resection and those who do not undergo anatomical resection for metastatic lung tumor should be followed more carefully due to poor prognosis.

Original languageEnglish
Pages (from-to)1026-1032
Number of pages7
JournalAnnals of Surgical Oncology
Volume16
Issue number4
DOIs
Publication statusPublished - Apr 2009
Externally publishedYes

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Colorectal Neoplasms
Lung Neoplasms
Neoplasm Metastasis
Lung
Disease-Free Survival
Survival Rate
Survival
Multivariate Analysis
Neoplasms
Kaplan-Meier Estimate
Taiwan
Recurrence

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Pulmonary resection for colorectal cancer metastases : Duration between cancer onset and lung metastasis as an important prognostic factor. / Lin, Been Ren; Chang, Tung Chen; Lee, Yung Chie; Lee, Po Huang; Chang, King Jen; Liang, Jin Tung.

In: Annals of Surgical Oncology, Vol. 16, No. 4, 04.2009, p. 1026-1032.

Research output: Contribution to journalArticle

Lin, Been Ren ; Chang, Tung Chen ; Lee, Yung Chie ; Lee, Po Huang ; Chang, King Jen ; Liang, Jin Tung. / Pulmonary resection for colorectal cancer metastases : Duration between cancer onset and lung metastasis as an important prognostic factor. In: Annals of Surgical Oncology. 2009 ; Vol. 16, No. 4. pp. 1026-1032.
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abstract = "Background: Pulmonary resection is the most effective treatment available for colorectal lung metastases. However, the characteristics of those patients most likely to benefit from surgical resection have not yet been adequately clarified. We have made a critical analysis for the potential prognostic factors and their clinical significance in lung metastasis from colorectal cancer. Methods: We analyzed 63 consecutive patients who underwent curative pulmonary resection for colorectal lung metastases at National Taiwan University Hospital from January 1997 to December 2006. Median follow-up was 37.3 (range 12-122) months. Disease-free and overall survival rates were evaluated by Kaplan-Meier analysis, and multivariate analyses of various prognostic characteristics were performed. Results: Overall 5-year survival and disease-free survival rates were 43.9{\%} and 19.5{\%}, respectively. Multivariate analysis showed that the interval for development of lung metastases from primary colorectal cancer and the mode of operation were the only two independent prognostic factors for survival. With regard to disease-free survival, the interval between initial resection of colorectal cancer and following lung metastases was the only significant independent prognostic factor. Besides, subset analysis showed that the 5-year survival rate in repeated resection group for recurrence of colorectal metastasis in residual lung was 85.7{\%}. Conclusion: Pulmonary resection, initial or even repeated resection for metastatic tumor from colorectal cancer should be encouraged for selected patients as it can significantly improve survival. Patients who have lung metastases within 1 year after primary tumor resection and those who do not undergo anatomical resection for metastatic lung tumor should be followed more carefully due to poor prognosis.",
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