J Korean Soc Coloproctol.  2007 Feb;23(1):53-59. 10.3393/jksc.2007.23.1.53.

Pulmonary Resection for Metastases from Colorectal Cancer: Prognostic Factors and Survival

• Yi LJ
• Lee WS
• Yun SH
• Chun HK
• Lee WY
• Yun HR
• Kim JG
• Kim KM
• Shim YM

• KMID: 2199234
• DOI: http://doi.org/10.3393/jksc.2007.23.1.53

Abstract

PURPOSE: Pulmonary metastases occur in up to 10% of all patients who undergo a curative resection for colorectal cancer. Surgical resection is an important part in the treatment of pulmonary metastasis from colorectal cancer. We analyzed the treatment outcome and the prognostic factors affecting survival in this subset of patients.
METHODS
Between October 1994 and December 2004, 59 patients underwent a curative resection for pulmonary metastases from colorectal cancer. Uncontrollable synchronous liver and lung metastasis or synchronous colorectal cancers with isolated lung metastasis were excluded from this study. A retrospective review of the patients' characteristics and of factors influencing survival was performed. Survival was analyzed by using the Kaplan-Meier method. Comparisons between the groups were performed by using a log-rank analysis and the Cox proportional hazard model.
RESULTS
The 5-year overall survival rate of all patients who received a pulmonary resection was 50.3%. The number of pulmonary metastases was significantly related with survival (P=0.032). A pre-thoracotomy CEA level exceeding 5 ng/ml was related with poor survival (P=0.001). A disease- free interval of greater than 2 years did not correlate with survival after a thoracotomy (P=0.3).
CONCLUSIONS
The pre-thoracotomy CEA level and the number of metastases were independent prognostic factors. Resection of a pulmonary metastasis from colorectal cancer may result in improved survival or even cure in selected patients. A pulmonary resection of colorectal cancer is regarded as a safe and effective treatment with low morbidity and mortality rates.

Keyword

Colorectal cancer; Metastases; Surgery; CEA; Recurrence

MeSH Terms

Colorectal Neoplasms*
Humans
Liver
Lung
Mortality
Neoplasm Metastasis*
Proportional Hazards Models
Recurrence
Retrospective Studies
Survival Rate
Thoracotomy
Treatment Outcome