Is Survival for Patients with Resectable Lung Metastatic Colorectal Cancer Comparable to Those with Resectable Liver Disease? Results from the South Australian Metastatic Colorectal Registry.

Abstract

Hepatic resection for colorectal (CRC) metastasis is considered a standard of care. Resection of metastasis isolated to lung also is considered potentially curable, although there is still some variation in recommendations. We explore outcomes for patients undergoing lung resection for mCRC, with the liver resection group as the comparator. South Australian (SA) metastatic CRC registry data were analysed to assess patient characteristics and survival outcomes for patients suitable for lung or liver resection. A total of 3241 patients are registered on the database to December 2014. One hundred two (3.1%) patients were able to undergo a lung resection compared with 420 (12.9%) who had a liver resection. Of the lung resection patients, 62 (61%) presented with lung disease only, 21% initially presented with liver disease only, 11% had both lung and liver, and 7% had brain or pelvic disease resection. Of these patients, 79% went straight to surgery without any neoadjuvant treatment and 34% had lung resection as the only intervention. Chemotherapy for metastatic disease was given more often to liver resection patients: 76.9 versus 53.9%, p=0.17. Median overall survival is 5.6years for liver resection and has not been reached for lung resection (hazard ratio 0.82, 95% confidence interval 0.54-1.24, p=0.33). Lung resection was undertaken in 3.1% of patients with mCRC in our registry. These data provide further support for long-term survival after lung resection in mCRC, survival that is at least comparable to those who undergo resection for liver metastasis in mCRC.