Pulmonary Resection for Metastases from Colorectal Cancer

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The lung is the most common extraabdominal site for metastases from colorectal cancer. Patients with untreated metastatic disease have a median survival of less than 10 months and a 5-year survival of less than 5%. The purpose of this study was to evaluate long-term survival in patients who underwent pulmonary resection for metastases from colorectal cancer. Between January 1990 and January 2005, 23 patients underwent 29 operations for resection of lung metastases. Median age was 68 years (range: 46-80 years). Median follow-up was 30 months (range: 12-149 months). The 2- and 5-year overall survival rates were 64 and 26%, respectively. Of the 23 patients, 16 patients had a solitary lesion, and seven patients had multiple lesions. The 5-year survival rates were 23 and 33%, respectively (not significant). The median disease-free interval (DFI)--the interval between colon resection and the appearance of lung metastases--was 43 months (1-168). Ten patients had DFIs <36 months, and 13 patients had DFIs >36 months. The 3-year survival rates were 20 and 38%, respectively (not significant). Recurrence of lung metastases was diagnosed in seven patients; three patients underwent second resections. They are alive today, with a median follow-up of 18 months. Patients who did not undergo second resections had a median survival of 12 months. Pulmonary resection for metastases from colorectal cancer does produce longer survival, even in patients with multiple lesions and recurrent metastases.