Korean J Hepatobiliary Pancreat Surg.  2016 Aug;20(3):110-115. 10.14701/kjhbps.2016.20.3.110.

Aggressive surgical resection for concomitant liver and lung metastasis in colorectal cancer

• Lee SH
• Kim SH
• Lim JH
• Kim SH
• Lee JG
• Kim DJ
• Choi GH
• Choi JS
• Kim KS

• KMID: 2351297
• DOI: http://doi.org/10.14701/kjhbps.2016.20.3.110

Abstract

BACKGROUNDS/AIMS
Aggressive surgical resection for hepatic metastasis is validated, however, concomitant liver and lung metastasis in colorectal cancer patients is equivocal.
METHODS
Clinicopathologic data from January 2008 through December 2012 were retrospectively reviewed in 234 patients with colorectal cancer with concomitant liver and lung metastasis. Clinicopathologic factors and survival data were analyzed.
RESULTS
Of the 234 patients, 129 (55.1%) had synchronous concomitant liver and lung metastasis from colorectal cancer and 36 (15.4%) had metachronous metastasis. Surgical resection was performed in 33 patients (25.6%) with synchronous and 6 (16.7%) with metachronous metastasis. Surgical resection showed better overall survival in both groups (synchronous, p=0.001; metachronous, p=0.028). In the synchronous metastatic group, complete resection of both liver and lung metastatic lesions had better survival outcomes than incomplete resection of two metastatic lesions (p=0.037). The primary site of colorectal cancer and complete resection were significant prognostic factors (p=0.06 and p=0.003, respectively).
CONCLUSIONS
Surgical resection for hepatic and pulmonary metastasis in colorectal cancer can improve complete remission and survival rate in resectable cases. Colorectal cancer with concomitant liver and lung metastasis is not a poor prognostic factor or a contraindication for surgical treatments, hence, an aggressive surgical approach may be recommended in well-selected resectable cases.

Keyword

Colorectal cancer; Liver cancer; Lung cancer; Metastasis

MeSH Terms

Colorectal Neoplasms*
Humans
Liver Neoplasms
Liver*
Lung Neoplasms
Lung*
Neoplasm Metastasis*
Retrospective Studies
Survival Rate

Figure

• 

  Fig. 1 Selection of study patients. Flow chart describes the characteristics of patients included in the analyses. CRC, colorectal cancer.

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  Fig. 2 Survival analysis for synchronous and metachronous metastasis from colorectal cancer. Survival analysis using the Kaplan-Meier method and log-rank test (A) in the synchronous metastasis group, the resection group showed significantly better survival compared to the non-resection group. (B) Complete resection for both liver and lung metastasis had significantly better survival compared to the incomplete resection group. (C) In the metachronous group, the resection group showed significantly better survival compared to the non-resection group.

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