725 Pulmonary metastases (PM) from colorectal cancer (CRC) treated by surgical resection. Prognostic factor analysis

Abstract

To select pts who will benefit from resection we conducted a retrospective prognostic factor analysis on pts with PM from CRC treated by surgical resection between 1970 and 1992. <h3>Population</h3> 86 pts have been analyzed; median age: 59 years; primary tumor: colon=49, rectum=37. 13 pts had prior resection of liver M and 12 received chemotherapy prior to resection of PM. The total number of intervention was 102 (bilateral=21). Resection was incomplete in 10 pts. The surgical procedure was a wedge resection in 63% of the cases, a lobectomy in 16%, a segmentectomy in 14%, and a pneumonectomy in 5%. No postoperative death occurred. <h3>Results</h3> overall survival was 24% at 5 years and 20% at 10 years. Prognostic factors of a better survival determined using univariate analysis were: a CEA level lower than 5ng/ml (<i>P</i>=0.0001), a complete resection (<i>P</i>=0.00001) and less than two metastases (<i>P</i>=0.03). Localization of the primary tumor, prior resection of liver metastases, size of the PM and time elapsed between the diagnosis and the resection of the PM did not influence survival. Using multivariate analysis, a low CEA level and a complete resection remained independent predictive factors (<i>P</i>=0.0001, <i>P</i>=0.03, respectively). <h3>Conclusion</h3> Surgical resection of PM allows long term survival especially for pts with a normal CEA level prior to surgery. The number of preoperative PM does not appear to be a limiting factor when lesions are totally resectable.