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Surgical resection of synchronous and metachronous lung and liver metastases of colorectal cancers
Annals of Surgical Treatment and Research ; : 82-89, 2017.
Article in English | WPRIM | ID: wpr-8204
ABSTRACT

PURPOSE:

Surgical resection of isolated hepatic or pulmonary metastases of colorectal cancer is an established procedure, with a 5-year survival rate of about 50%. However, the role of surgical resections in patients with both hepatic and pulmonary metastases is not well established. We aimed to analyze overall survival of these patients and associated factors.

METHODS:

Data retrospectively collected from 66 patients who underwent both hepatic and pulmonary metastasectomy after colorectal cancer surgery from August 2002 through August 2013 were analyzed. In univariate analysis, the log-rank test compared patient survival between groups. P < 0.1 was considered indicative of significance. Multivariate analysis of the significance data using a Cox proportional hazard model identified factors associated with overall survival. The synchronous group (n = 57) was defined as patients who had metastasectomy within 3 months from primary colorectal cancer surgery. The remaining nine patients constituted the metachronous group.

RESULTS:

Median follow-up was 126 months from the primary colorectal cancer surgery. The 5-year survival was 73.4%. There was no difference in overall survival between the synchronous and metachronous groups, consistent with previous studies. Distribution (involving one hemiliver or both, P = 0.010 in multivariate analysis) of liver metastases and multiplicity of the pulmonary metastasis (P = 0.039) were predictors of poor prognosis.

CONCLUSION:

Sequential or simultaneous resection of both hepatic and pulmonary metastasis of colorectal cancer resulted in good long-term survival in selected patients. Thus, an aggressive surgical approach and multidisciplinary decision making with surgeons seems to be justified.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Colorectal Neoplasms / Proportional Hazards Models / Multivariate Analysis / Survival Rate / Retrospective Studies / Follow-Up Studies / Decision Making / Metastasectomy / Surgeons Type of study: Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Annals of Surgical Treatment and Research Year: 2017 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Colorectal Neoplasms / Proportional Hazards Models / Multivariate Analysis / Survival Rate / Retrospective Studies / Follow-Up Studies / Decision Making / Metastasectomy / Surgeons Type of study: Observational study / Prognostic study / Risk factors Limits: Humans Language: English Journal: Annals of Surgical Treatment and Research Year: 2017 Type: Article