Abstract
ObjectiveTo analyze the benefits and prognostic factors after surgical resection of pulmonary metastases from colorectal cancer (CRC).MethodsFrom Jan. 2004 to Jan. 2015, continuous 88 cases diagnosed with pulmonary metastases from CRC, including 15 cases of synchronous metastases and 73 metachronous metastases, were analyzed in the retrospective study.ResultsAll of these 88 cases underwent curative pulmonary resection including 8 cases of simultaneous surgery. The one-year, three-year and five-year survival of the 88 cases were 93.4%, 60.2% and 35.7%, respectively. 63 patients just have one metastasis, and 25 patients have more than one metastasis. Additionally, the one-year, three-year and five-year survival was 98.1%, 70.2% and 40.3% respectively in one metastasis group, while 80.1%, 37.9% and 22.5% respectively in more than one metastasis group (p = 0.003). DFS of 37 metachronous metastases were equal or greater than 18 months, and DFS of 36 metachronous metastases were less than 18 months. The one-year, three-year and five-year survival was 97.8%, 77.9% and 41.4% respectively in the DFS≥18 month group, while 88.2%, 44.6% and 28.1% respectively in the DFS<18 month group (p = 0.01).ConclusionSurgical resection of pulmonary metastases from colorectal cancer can improve survival rate in selected patients. It seems that the number of metastases is an independence prognostic factor in surgical treatment. Furthermore, longer DFI implies longer survival for resectable CRC pulmonary metastases.
Highlights
Distant metastases, especially liver and lung, are nearly the most significant prognostic factor for colorectal cancer (CRC)
disease free survival (DFS) of 37 metachronous metastases were equal or greater than 18 months, and DFS of 36 metachronous metastases were less than 18 months
Surgical resection of pulmonary metastases from colorectal cancer can improve survival rate in selected patients. It seems that the number of metastases is an independence
Summary
Especially liver and lung, are nearly the most significant prognostic factor for colorectal cancer (CRC). Lung is the secondary frequent target organ for metastasis, and pulmonary and hepatic metastases are regarded as the limited diseases in some studies [1]. Though chemotherapy, targeted therapy, radiofrequency ablation and other new progressed therapeutic methods are applied in the treatment of pulmonary metastases from CRC, the five-year overall survival rate is still no more than 5% by systemic therapy[2]. Surgical resection is widely accepted as the choice for tackling pulmonary metastases from CRC[3, 4]. There are still arguments on surgical indications and prognostic factors[5,6,7,8]. The indication for pulmonary resection, such as resection of recurrent lung metastases[9], has become broad
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