Factors Influencing Survival after Curative Resection of Pulmonary Metastasis from Colorectal Cancer

ABSTRACT

PURPOSE: About 10 percent of patients with colorectal cancer develop pulmonary metastases, but selection of patients for resection of lung metastases is difficult problem. This study was performed to identify prognostic factors after resection of pulmonary metastases from colorectal cancer. METHODS: We reviewed retrospectively the clinical course of 64 patients who underwent surgical resection of primary colorectal cancer and metastatic lung disease at the Yonsei University College of Medicine between November 1994 and January 2005. We analyzed the prognostic factors with special reference of the clinicopathologic factors of primary tumors. Univariate and multivariate analyses of survival were used to identify significant prognostic factors. RESULTS: Overall five-year survival rate after resection of lung metastases was 38.4 %. The mean size of the largest metastatic nodules is 2.73 cm. The median interval between colorectal resection and lung resection (disease free interval) was 28.7 months. The disease free interval, number and size of the pulmonary metastases were not significant prognostic factor. The negative hilar lymph node metastasis, colon cancer rather than rectal cancer, normal serum CEA were significant prognostic factors in multivariate analysis. CONCLUSION: Pulmonary resection for metastases from colorectal cancer may help prolong survival in selected patients. In this study, we found that if patients had negative pulmonary hilar lymph node metastases, normal range of serum CEA, and colon cancer rather than rectal cancer, the prognosis preferable than others.