Prognostic factors related to simple lung metastases in 90 patients with primary colorectal cancer / 肿瘤

ABSTRACT

Objective: To investigate the prognostic factors related to overall survival and prognosis of patients with simple lung metastases from primary colorectal cancer. Methods: The clinical data from 90 patients with simple lung metastases from primary colorectal cancer were retrospectively reviewed. Of these 90 patients, 34 received R0 resection of lung metastases, and 56 received systemic chemotherapy. The survival analysis was performed by Kaplan-Meier method. The log-rank test was used for univariate analysis and the COX proportional hazards model for multivariate analysis of prognosis. Results: The 1-, 2- and 3-year cumulative survival rates between the patients receiving R0 resection of lung metastases and systemic chemotherapy were significantly different (97.1% vs 82.1%, P < 0.05; 88.2% vs 55.3%, P < 0.05; 74.9% vs 31.4%, P < 0.05). The 1-, 2- and 3-year disease-free survival rates of patients receiving R0 resection of lung metastases were 64.7%, 43.9% and 33.8%, respectively. The univariate analysis revealed that in patients receiving R0 resection of lung metastases, the factors of hilar or mediastinal lymph node metastases (P = 0.003), the maximum tumor size of pulmonary metastases (P = 0.007) and preoperative serum carcinoembryonic antigen level (P = 0.029) were significantly correlated with the 3-year overall survival, and the factors of lymph node metastases after curative resection of colorectal cancer (P = 0.005), the maximum diameter of pulmonary metastases more than or equal to 4 cm (P = 0.006) and preoperative serum carcinoembryonic antigen level more than or equal to 5 ng/mL (P = 0.010) were significantly correlated with the recurrence after R0 resection of lung metastases, while in patients receiving systemic chemotherapy, the factor of use of all three cytotoxic agents including fluorouracil, oxaliplatin and irinotecan (P = 0.004) was significantly correlated with the 3-year overall survival. The mulitivariate analysis revealed that in patients receiving R0 resection of lung metastases, the factor of maximum diameter of pulmonary metastases more than or equal to 4 cm (P = 0.032) was an independent prognostic factor related to the 3-year overall survival, while the factors of positive lymph node metastases after curative resection of the primary colorectal cancer (P = 0.030) and the maximum diameter of pulmonary metastases more than or equal to 4 cm (P = 0.049) were independent prognostic factors related to the recurrence after R0 resection of lung metastases. Conclusion: The overall survival of patients receiving R0 resection of lung metastases from primary colorectal cancer especially for the patients with the maximum diameter of pulmonary metastases less than 4 cm can be significantly improved. The overall survival of patients receiving systemic chemotherapy using all three cytotoxic agents including fluorouracil, oxaliplatin and irinotecan can also be significantly prolonged. Copyright © 2013 by TUMOR.